CASE REPORT
Extracorporeal carbon dioxide removal to "protect" the lung
Adult Intensive Care Unit, Royal Brompton Hospital, London, UK
Correspondence to:
Dr S J Finney, Adult Intensive Care Unit, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK; s.finney{at}imperial.ac.uk
The case histories are presented of three adults who had severe hypercapnic acidosis despite mechanical ventilation with what were considered to be injurious tidal volumes and airway pressures. The use of a percutaneously inserted arteriovenous extracorporeal carbon dioxide removal (AV-ECCO2R) device facilitated a dramatic reduction in the amount of ventilatory support required, achieving a "lung-protective" level. Two patients survived to hospital discharge. One patient died after it became apparent that her late-stage interstitial lung disease was unresponsive to immunosuppression. AV-ECCO2R may be a useful strategy in facilitating lung-protective ventilation.
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