Place de l’épuration extracorporelle de CO2 (ECCO2R) dans la prise en charge des pathologies respiratoires

Translated title of the contribution: The role of extracorporeal removal of CO2 (ECCO2R) in the management of respiratory diseases

J. L. Diehl, J. Boisramé-Helms, A. Chardon-Couteau, M. Commereuc, J. L. Augy, A. Sokoloff, N. Rivet, P. Gaussem, D. M. Smadja, N. Aissaoui

Research output: Contribution to journalShort survey

Abstract

Introduction The aim of extracorporeal removal of CO2 (ECCO2R) is to ensure the removal of CO2 without any significant effect on oxygenation. ECCO2R makes use of low to moderate extracorporeal blood flow rates, whereas extracorporeal membrane oxygenation (ECMO) requires high blood flows. State of the art For each ECCO2R device it is important to consider not only performance in terms of CO2 removal, but also cost and safety, including the incidence of hemolysis and of hemorrhagic and thrombotic complications. In addition, it is possible that the benefits of such techniques may extend beyond simple removal of CO2. There have been preliminary reports of benefits in terms of reduced respiratory muscle workload. Mobilization of endothelial progenitor cells could also occur, in analogy to the data reported with ECMO, with a potential benefit in term of pulmonary repair. The most convincing clinical experience has been reported in the context of the acute respiratory distress syndrome (ARDS) and severe acute exacerbations of chronic obstructive pulmonary disease (COPD), especially in patients at high risk of failure of non-invasive ventilation. Perspectives Preliminary results prompt the initiation of randomized controlled trials in these two main indications. Finally, the development of these technologies opens new perspectives in terms of long-term ventilatory support.

Translated title of the contributionThe role of extracorporeal removal of CO2 (ECCO2R) in the management of respiratory diseases
Original languageFrench
Pages (from-to)345-353
Number of pages9
JournalJournal Europeen des Urgences et de Reanimation
Volume29
Issue number4
DOIs
StatePublished - Dec 2017

All Science Journal Classification (ASJC) codes

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

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