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) |