title: [Extracorporeal CO2removal as an alternative to tracheotomy in a patient with extubation failure].
abstract: We report a patient with chest trauma who was admitted to the ICU after surgery. As he fulfilled protocol-based criteria, he was extubated 7 days after admission. However, despite intermittent non-invasive ventilation, the patient had to be re-intubated on day 10 owing to progressive hypercapnia. We decided to support the patient with a mid-flow veno-venous extracorporeal carbon dioxide removal (ECCO2‑R) system instead of a tracheotomy. Sufficient CO2removal was established with a blood flow of 1.5 l/min and the patient was successfully extubated within a few hours. After 5 days of ECCO2‑R the patient could be weaned and transferred to a general ward in a stable condition.
authors.affiliation: Klinik für Anästhesiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland. andreas.redel@ukr.de.
authors.forename: A
authors.initials: A
authors.lastname: Redel
authors.affiliation: Klinik für Chirurgie, Universitätsklinikum Regensburg, Regensburg, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Ritzka
authors.affiliation: Klinik für Anästhesiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Kraus
authors.affiliation: Klinik für Herz-Thorax-Chirurgie, Universitätsklinikum Regensburg, Regensburg, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Philipp
authors.affiliation: Klinik für Chirurgie, Universitätsklinikum Regensburg, Regensburg, Deutschland.
authors.forename: H-J
authors.initials: HJ
authors.lastname: Schlitt
authors.affiliation: Klinik für Anästhesiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
authors.forename: B
authors.initials: B
authors.lastname: Graf
authors.affiliation: Klinik für Anästhesiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Bein
mesh_terms: D000369:Aged, 80 and over; D060666:Airway Extubation / Q000379:methods*; D002245:Carbon Dioxide / Q000097:blood*; D005112:Extracorporeal Circulation; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D006801:Humans; D006935:Hypercapnia / Q000628:therapy*; D008297:Male; D063087:Noninvasive Ventilation; D014140:Tracheotomy / Q000379:methods*; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D002245:Carbon Dioxide
keywords: Extracorporeal CO2 removal; Hypercapnia; Intensive care medicine; Tracheotomy; Veno-venous ECMO