Applying a low-flow CO2 removal device in severe acute hypercapnic respiratory failure

A.S. Sharma, Patrick Weerwind, U. Strauch, A. van Belle, Jos Maessen, E.F. Wouters

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

A novel and portable extracorporeal CO2-removal device was evaluated to provide additional gas transfer, auxiliary to standard therapy in severe acute hypercapnic respiratory failure. A dual-lumen catheter was inserted percutaneously in five subjects (mean age 55+/-0.4 years) and, subsequently, connected to the CO2-removal device. The median duration on support was 45 hours (interquartile range 26-156), with a blood flow rate of approximately 500 mL/min. The mean PaCO2 decreased from 95.8+/-21.9 mmHg to 63.9+/-19.6 mmHg with the pH improving from 7.11+/-0.1 to 7.26+/-0.1 in the initial 4 hours of support. Three subjects were directly weaned from the CO2-removal device and mechanical ventilation, one subject was converted to ECMO and one subject died following withdrawal of support. No systemic bleeding or device complications were observed. Low-flow CO2 removal adjuvant to standard therapy was effective in steadily removing CO2, limiting the progression of acidosis in subjects with severe acute hypercapnic respiratory failure.
Original languageEnglish
Pages (from-to)149-155
Number of pages7
JournalPerfusion
Volume31
Issue number2
Early online date3 Jun 2015
DOIs
Publication statusPublished - Mar 2016

Keywords

  • acute hypercapnic respiratory failure
  • COPD
  • acidosis
  • extracorporeal CO2 removal
  • low-flow
  • EXTRACORPOREAL MEMBRANE-OXYGENATION
  • CARBON-DIOXIDE REMOVAL
  • NONINVASIVE VENTILATION
  • CLINICAL-TRIAL
  • EXACERBATIONS
  • PREDICTORS
  • MORTALITY
  • SURVIVAL

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