Extracorporeal Removal CO2 Using a Venovenous, Low-Flow System (Decapsmart) in a Lung Transplanted Patient: A Case Report

Extracorporeal Carbon Dioxide Removal (ECCO2R) in Respiratory Failure: An Overview, and where Next?

“…Hence the complication rates in Table 2 are from the most recent prospective study of AV-ECCO 2 R. 14 The complication rates for VV-ECCO 2 R in this table are compiled from the 18 cases of its use that are reported in the literature. 9,10,11,12,34 The other complications of AV-ECCO 2 R that have been reported in the literature are: plasma leakage, heparin-induced thrombocytopenia, 24 and haemolysis. 18 There has also been a report of critical hypotension when AV-ECCO 2 R was initiated in a patient who had severe hypoxia and septic shock.…”

Extracorporeal Carbon Dioxide Removal: The Future of Lung Support Lies in the History

“…The low resistance properties of the ECLA devices allow hemofilter to be connected in series or parallel and prevent the patient from an extravascular access. DECAPSMART is a classic example of pulmonary/renal support and has been used successfully in isolated instances [10,74]. This adaptation can also be extended to other ECCO2R devices and can also be used with AVCO2R [75].…”

Extracorporeal CO₂ Removal

“…[7] Pietropaoli and coworkers described the use of this new generation ECCO 2 R to assist a patient affected by primary graft dysfunction after a single lung transplantation. Although this system should not be considered a replacement for traditional ECMO, because the performances are not comparable in terms of CO 2 removal and especially oxygenation improvement, available data suggest that this "mini-ECMO" optimize pH values, reduce partial pressure of CO 2 allowing to minimize ventilatory support and therefore minimizing VILI with no adverse events in terms of bleeding, circuit clotting, severe hemodynamic instability, or venous embolism [24].…”

“…This characteristic of the circuit increases the pressure inside the membrane lung by adding the downstream resistance exerted by the hemofilter and therefore reduces the risk of air bubble formation; minimizes the need for heparin by diluting the blood entering the membrane lung by recirculating the plasmatic water separated by the hemofilter; produces a performance enhancement of the extracorporeal device extracting the carbon dioxide dissolved in the plasmatic water separated by the hemofilter and recirculated through the membrane lung. [7,23,24,26] Extracorporeal CO2 removal: the future Terragni e coll. managed effectively and safely respiratory acidosis consequent to Vt lower than 6 L/kg PBW and reestablished a normal arterial pH through extracorporeal carbon dioxide removal technique.…”