title: Extracorporeal CO2 removal: Technical and physiological fundaments and principal indications.
abstract: In recent years, technological improvements have reduced the complexity of extracorporeal membrane oxygenation devices. This have enabled the development of specific devices for the extracorporeal removal of CO2. These devices have a simpler configuration than extracorporeal membrane oxygenation devices and uses lower blood flows which could reduce the potential complications. Experimental studies have demonstrated the feasibility, efficacy and safety of extracorporeal removal of CO2 and some of its effects in humans. This technique was initially conceived as an adjunct therapy in patients with severe acute respiratory distress syndrome, as a tool to optimize protective ventilation. More recently, the use of this technique has allowed the emergence of a relatively new concept called "tra-protective ventilation"whose effects are still to be determined. In addition, the extracorporeal removal of CO2 has been used in patients with exacerbated hypercapnic respiratory failure with promising results. In this review we will describe the physiological and technical fundamentals of this therapy and its variants as well as an overview of the available clinical evidence, focused on its current potential.
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario Mútua de Terrassa, Universidad de Barcelona, Terrassa, Barcelona, España.
authors.forename: E
authors.initials: E
authors.lastname: Romay
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario Mútua de Terrassa, Universidad de Barcelona, Terrassa, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, España. Electronic address: rferrer@mutuaterrassa.es.
authors.forename: R
authors.initials: R
authors.lastname: Ferrer
mesh_terms: D002245:Carbon Dioxide; D015199:Extracorporeal Membrane Oxygenation; D006801:Humans; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome; D012131:Respiratory Insufficiency / Q000628:therapy*
chemical_list: D002245:Carbon Dioxide
keywords: Carbon dioxide; Circulación extracorpórea; Dióxido de carbono; Enfermedad pulmonar obstructiva crónica; Extracorporeal circulation; Pulmonary disease, chronic obstructive; Respiración artificial; Respiration, artificial; Respiratory distress syndrome, adult; Síndrome de distrés respiratorio