title: Extracorporeal carbon dioxide removal to "protect" the lung.
abstract: 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-ECCO(2)R) 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-ECCO(2)R may be a useful strategy in facilitating lung-protective ventilation.
authors.affiliation: Adult Intensive Care Unit, Royal Brompton Hospital, Sydney Street, London, UK.
authors.forename: S L
authors.initials: SL
authors.lastname: Stirling
authors.forename: J J
authors.initials: JJ
authors.lastname: Cordingley
authors.forename: D N
authors.initials: DN
authors.lastname: Hunter
authors.forename: M J
authors.initials: MJ
authors.lastname: Griffiths
authors.forename: S J
authors.initials: SJ
authors.lastname: Wort
authors.forename: T W
authors.initials: TW
authors.lastname: Evans
authors.forename: S J
authors.initials: SJ
authors.lastname: Finney
mesh_terms: D000142:Acidosis, Respiratory / Q000628:therapy*; D000328:Adult; D000368:Aged; D002245:Carbon Dioxide / Q000378:metabolism*; D005112:Extracorporeal Circulation / Q000379:methods*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D006935:Hypercapnia / Q000628:therapy*; D055370:Lung Injury / Q000517:prevention & control; D008297:Male; D011659:Pulmonary Gas Exchange / Q000502:physiology*; D012121:Respiration, Artificial / Q000379:methods; D013990:Tidal Volume
chemical_list: D002245:Carbon Dioxide