Martínez GJP, Jiménez RI, Sánchez SEM, Roa AD, Mohedano GA, Suarez SJ

Language: Spanish
References: 12
Page: 193-197
PDF size: 291.49 Kb.

ABSTRACT

Extracorporeal carbon dioxide purification therapy (ECCO₂R) is a technology that has made its way into the field of respiratory failure in the daily life of intensive care units. Gattinoni et al. was the first to suggested the need to separate extracorporeal oxygenation support from purely ventilatory support. This led to the birth of ECCO₂R, which was developed as a support for patients with severe acute respiratory distress syndrome (ARDS) with the aim of maintaining protective ventilation when permissive hypercapnia is not well tolerated or there is a formal contraindication. However, hemodynamic and technological advances that increasingly simplify the use of ECMO, added to the severe hypoxemia that these patients usually suffer, prompted extracorporeal membrane oxygenation (ECMO) over ECCO₂R. Case series have been studied in which ECCO₂R has been used for the management of purely hypercapnic respiratory failure, mainly in exacerbations of patients with COPD, cases of bronchopleural fistulas or fatal asthmatic status. Unfortunately, the lack of robust studies that support the scientific evidence of the ECCO₂R in these cases means that the formal indications for this device are limited and more experience and scientific evidence is needed in its favor. This manuscript describes the experience that we have accumulated in our center through two cases of inventilable asthmatic status and ECCO₂R.

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