Use of Extracorporeal CO2 Removal to Avoid Invasive Mechanical Ventilation in Hypercapnic Coma and Failure of Noninvasive Ventilation
Markus Engel*, Henriette Albrecht and Stefan Volz
Department of Cardiology and Intensive Care Medicine, Bogenhausen Hospital Heart Center, Munich Municipal Hospital Group, Englschalkinger Strasse 77, München, Germany
- Corresponding Author:
- Markus Engel
Department of Cardiology and Intensive Care Medicine
Bogenhausen Hospital Heart Center, Munich Municipal Hospital Group
Englschalkinger Strasse 77, München, Germany
Tel: +49 (089) 9270- 2732
Fax: +49 (089) 9270-2683
E-mail: [email protected]
Received date: April 19, 2016; Accepted date: June 22, 2016; Published date: June 25, 2016
Citation: Engel M, Albrecht H, Volz S (2016) Use of Extracorporeal CO2 Removal to Avoid Invasive Mechanical Ventilation in Hypercapnic Coma and Failure of Noninvasive Ventilation. J Pulm Respir Med 6:357. doi:10.4172/2161-105X.1000357
Copyright: © 2016 Engel M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Invasive mechanical ventilation is known to be detrimental to patients with respiratory failure due to acute exacerbation of chronic obstructive pulmonary disease (AECOPD). If hypercapnic respiratory failure and acidosis cannot be controlled by noninvasive mechanical ventilation, extracorporeal carbon dioxide removal (ECCO2 R) serves as an alternative option. Currently applied systems like extracorporeal membrane oxygenation (ECMO) or pumpless extracorporeal lung assist (PECLA) are associated with potentially significant bleeding complications and require a very high nursing standard. We report a case of AECOPD with hypercapnic coma and failure of noninvasive ventilation for which we used a novel low-flow ECCO2 R device, called the Hemolung Respiratory Assist System. This device requires only a single 15.5 French double-lumen venous catheter and operates at blood flows of 350 mL/min to 550 mL/min. Use of this device enabled the patient to avoid general anesthesia and invasive mechanical ventilation without adverse events. In addition, weaning from noninvasive mechanical ventilation, early mobilization, communication and nutrition were facilitated. CO2 removal with low extracorporeal blood flow avoided intubation in the treatment of hypercapnic coma with failure of non-invasive ventilation.