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Table 1 Relevant clinical studies of ECCO2R in COPD

From: Extracorporeal carbon dioxide removal for acute hypercapnic respiratory failure

References No. of patients ECCO2R characteristics Time on ECCO2R Major results
Configuration Blood flow (mL/min) Sweep flow (L/min) Membrane (material); surface in m2
ECCO2R to avoid mechanical ventilation
 Kluge et al. [5] 21 Femoral AV with 13- to 15-Fr arterial cannula and 13- to 17-Fr venous cannula 1100 Not reported PMP; 1.3 (iLA®) 9 days 19 (90%) PECLA patients did not require intubation
Two major and seven minor bleeding complications during PECLA
No significant difference in 28-day (24 vs. 19%, p = 0.85), 6-month mortality (33 vs. 33%), or hospital length of stay (23 vs. 42 days, p = 0.06)
Significantly fewer tracheostomies in PECLA group (10 vs. 67%, p = 0.004)
 Del Sorbo et al. [4] 25 Modified continuous VV hemofiltration system with membrane
lung via 14-Fr single dual-lumen cannula (femoral)
255 8 PLP; 1.35 (Hemodec DecapSmart®) 1–2 days Significantly higher risk of intubation in NIV-only group (HR 0.27; 95% CI 0.07–0.98)
13 patients experienced adverse events: three had bleeding, one had vein perforation, and nine had device malfunction
 Braune et al. [43] 25 VV configuration via a 22 or 24-Fr single dual-lumen cannula (femoral or jugular) 1300 Not reported PMP; 1.3 (Novalung iLA Activve) 8.5 days Intubation was avoided in 14 out of all 25 ECCO2R patients (56%)
Seven ECCO2R patients were intubated because of progressive hypoxemia and four due to ventilatory failure despite ECCO2R and NIV
Nine ECCO2R patients (36%) suffered from major bleeding complications
90-day mortality rates were 28 vs. 28%
Study No. of patients ECCO2R characteristics Time on ECCO2R Major results
Configuration Blood flow (mL/min) Sweep flow (mL/min) Membrane surface (m2)
ECCO2R to facilitate liberation from mechanical ventilation
 Abrams et al. [3] 5 VV configuration via a 20- to 24-Fr single dual-lumen jugular
catheter using lower flow on ECMO system
1700 1–7 PMP; 0.98 (Maquet PALP CardioHelp) 8 days Mean (SD) time to ambulation after ECCO2R initiation was 29.4 ± 12.6 h
Four patients were discharged home, and one underwent planned lung transplantation
Only two minor bleeding complications
 Cardenas et al. [46] 1 VV configuration with pediatric dual-lumen jugular cannula 800 10 PMP; 1.8 (Quadrox-d, Maquet) 3.6 days Patient extubated 48 h after decannulation. No complications reported
 Roncon et al. [47]        
ECCO2R with mixed indications
 Burki [42] 20 VV configuration via a 15.5-Fr single dual-lumen catheter (femoral or jugular) 430 Not reported PLP with a base of siloxane layer; 0.59 (ALung Hemolung RAS) 2–192 h 20 hypercapnic COPD patients received ECCO2R in three distinct groups: group 1 (n = 7) NIV patients with high risk of IMV; group 2 (n = 2) could not be weaned from NIV; and group 3 (n = 11) on IMV and failed to wean
IMV avoided in all patient in group 1
Both patients in group 2 weaned from NIV
In group 3, three patients weaned, and IMV was reduced in two patients
One patient died due to a retroperitoneal hemorrhage (during cannulation)
  1. PMP poly-4-methyl-1-pentene, PLP polypropylene