A randomised controlled trial of non-invasive ventilation compared with extracorporeal carbon dioxide removal for acute hypercapnic exacerbations of chronic obstructive pulmonary disease.

Background: Patients presenting with acute hypercapnic respiratory failure due to exacerbations of chronic obstructive pulmonary disease (AECOPD) are typically managed with non-invasive ventilation (NIV). The impact of low-flow extracorporeal carbon dioxide removal (ECCOR) on outcome in these patients has not been explored in randomised trials.

Methods: Open-label randomised trial comparing NIV (NIV arm) with ECCOR (ECCOR arm) in patients with AECOPD at high risk of NIV failure (pH < 7.