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Table 3 Case series of ECCO2R for near fatal asthma

From: Extracorporeal carbon dioxide removal for acute hypercapnic respiratory failure

References ECCO2R technique Major findings
Sakai et al. [52] Extracorporeal lung assist (ECLA); 22 Fr drainage and 18 Fr return femoro-femoral cannula with a median blood flow rate of 1.7–2 L/min 23 year old
Gas exchange with IMV before ECCO2R: pH 7.02, paCO2 100 mmHg, PaO2 50 mmHg (FiO2 100%)
Weaning achieved after 20 h of ECLA was commenced
Extubation 2 days after ECLA
No complications reported
Elliot et al. [53] Femoral AV pumpless extracorporeal lung assist (PECLA)
15-Fr arterial cannula and 17-Fr venous cannula with a mean extracorporeal blood flow of 1.5 L/min
Case 1: 74 year old. Gas exchange with IMV before ECCO2R: pH 6.87, paCO2 147 mmHg. Extubation after 48 h of ECLA. Complications: Coagulation of membrane that needed changing. Bleeding through femoral artery
Case 2: 52 year old. Gas exchange with IMV before ECCO2R: pH 7.2, paCO2 130 mmHg. ECCO2R duration: 5 days
Extubated on intensive care day 11. No complications reported
Jung et al. [54] Femoral AV pumpless extracorporeal lung assist (PECLA)
15-Fr arterial cannula and 17-Fr venous cannula with a mean extracorporeal blood flow of > 1.5 L/min
42 year old
No gas exchange before IMV reported. Patient successfully extubated and transferred from the ICU on day 14 of admission
No complications reported
Brenner et al. [51] Dual-lumen catheter 20–23 Fr bicaval, inserted into the right internal jugular vein with blood flow of 1.3 to 1.8 L/min Case 1: 48 years old. Gas exchange with IMV before ECCO2R: pH 6.94, paCO2 147 mmHg, PaO2 416 mmHg (FiO2 100%). Successfully extubated while on ECCO2R and discharged from ICU. No complications reported
Case 2: 59 years old. Gas exchange with IMV before ECCO2R: pH 7.12, paCO2 78 mmHg, PaO2 112 mmHg (FiO2 100%). ECCO2R duration: 9 days. Ventilator support discontinued on day 28 due to critical illness neuromyopathy
Schneider et al. [55] Awake dual-lumen catheter 22 Fr bicaval, inserted into the right internal jugular vein with blood flow of 0.6–1.5 L/min 67 years old
Gas exchange before ECCO2R (on NIV): pH 7.24, paCO2 61 mmHg, PaO2 289 mmHg (FiO2 100%)
Thirty-four hours after initiating ECCO2R, the patient was weaned entirely from NIV, and the cannula could be removed without any complication. On day 4, the patient was discharged from the ICU without the need for supplemental oxygen and 6 days later, discharged from hospital without any impairment
  1. IMV invasive mechanical ventilation, NIV noninvasive mechanical ventilation