Recently, advancements in extracorporeal carbon dioxide removal (ECCO2R) technology have markedly enhanced its clinical applicability and efficacy for managing severe respiratory conditions. This review highlights critical innovations in ECCO2R, such as advanced catheter technologies, active mixing methods, and biochemical enhancements, which have substantially improved gas exchange efficiency and broadened the scope of ECCO2R applications. Integrating ECCO2R into acute and chronic respiratory care has led to a shift toward more mobile and less invasive modalities, promising for extending ECCO2R usage from intensive care units to home settings. By examining these technological advancements and their clinical impacts, this paper outlines the potential future directions of ECCO2R technology, emphasizing its role in transforming respiratory care practices and enhancing patient outcomes.
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http://dx.doi.org/10.4103/mgr.MEDGASRES-D-24-00051 | DOI Listing |
Crit Care
December 2024
Department of Anesthesia and Intensive Care Unit, Regional University Hospital of Montpellier, St-Eloi Hospital, PhyMedExp, INSERM U1046, CNRS UMR, University of Montpellier, 9214, Montpellier Cedex 5, France.
Background: Ultra-protective ventilation is the combination of low airway pressures and tidal volume (Vt) combined with extra corporeal carbon dioxide removal (ECCOR). A recent large study showed no benefit of ultra-protective ventilation compared to standard ventilation in ARDS (Acute Respiratory Distress Syndrome) patients. However, the reduction in Vt failed to achieve the objective of less than or equal to 3 ml/kg predicted body weight (PBW).
View Article and Find Full Text PDFAim: The optimal arterial partial pressure of carbon dioxide (PaCO) for patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) remains unknown. We aimed to investigate the association between post-resuscitation PaCO and neurological outcomes.
Methods: This retrospective cohort study analyzed data from the Study of Advanced Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan, a multicenter registry study across 36 hospitals in Japan, including patients with out-of-hospital cardiac arrest (OHCA) admitted to intensive care units (ICU) after ECPR between 2013 and 2018.
ERJ Open Res
November 2024
Anaesthesia and Intensive Care Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy.
Introduction: High-frequency percussive ventilation (HFPV) is a ventilation mode characterised by high-frequency breaths. This study investigated the impact of HFPV on gas exchange and clinical outcomes in acute respiratory failure (ARF) patients during spontaneous breathing, noninvasive ventilation (NIV) and invasive mechanical ventilation (iMV).
Methods: This systematic review included randomised and nonrandomised studies up to August 2023.
J Artif Organs
December 2024
Department of Anaesthesiology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
The use of veno-venous extracorporeal membrane oxygenation (VV-ECMO) has become increasingly prevalent, particularly in respiratory disease pandemics such as H1N1-influenza and SARS-CoV-2. This surge has emphasized the importance of clear therapy recommendations, improved accessibility to ECMO technology, established ECMO teams, and structured networks to ensure access to specialized care throughout the course of the disease for patients with severe ARDS. Although the initiation criteria for VV-ECMO are well defined, treatment strategies while on ECMO regarding e.
View Article and Find Full Text PDFCOPD
December 2024
Department of Critical Care, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
Rationale: The impact of extracorporeal carbon dioxide removal (ECCOR) on work of breathing and aeration in exacerbations of chronic obstructive pulmonary disease (AECOPD) is poorly understood.
Objectives: The study explores the impact of non-invasive ventilation (NIV) and ECCOR on respiratory drive, effort and distribution of ventilation in AECOPD.
Methods: Patients enrolled in a randomised controlled study of the addition of ECCOR to NIV compared with NIV underwent oesophageal pressure measurement, electrical impedance tomography and parasternal electromyography.
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