Cove Matthew E, MacLaren Graeme, Federspiel William J, Kellum John A
Crit Care. 2012 Sep 21;16(5):232. doi: 10.1186/cc11356.
Acute respiratory distress syndrome (ARDS) has a substantial mortality rate and annually affects more than 140,000 people in the USA alone. Standard management includes lung protective ventilation but this impairs carbon dioxide clearance and may lead to right heart dysfunction or increased intracranial pressure. Extracorporeal carbon dioxide removal has the potential to optimize lung protective ventilation by uncoupling oxygenation and carbon dioxide clearance. The aim of this article is to review the carbon dioxide removal strategies that are likely to be widely available in the near future. Relevant published literature was identified using PubMed and Medline searches. Queries were performed by using the search terms ECCOR, AVCO2R, VVCO2R, respiratory dialysis, and by combining carbon dioxide removal and ARDS. The only search limitation imposed was English language. Additional articles were identified from reference lists in the studies that were reviewed. Several novel strategies to achieve carbon dioxide removal were identified, some of which are already commercially available whereas others are in advanced stages of development.
急性呼吸窘迫综合征（ARDS）死亡率颇高，仅在美国每年就影响超过14万人。标准治疗包括肺保护性通气，但这会损害二氧化碳清除，并可能导致右心功能障碍或颅内压升高。体外二氧化碳清除有可能通过将氧合与二氧化碳清除解耦来优化肺保护性通气。本文旨在综述近期可能广泛应用的二氧化碳清除策略。通过PubMed和Medline检索确定相关已发表文献。使用检索词ECCOR、AVCO2R、VVCO2R、呼吸透析以及将二氧化碳清除与ARDS相结合进行查询。唯一的检索限制是英文文献。从所综述研究的参考文献列表中识别出其他文章。确定了几种实现二氧化碳清除的新策略，其中一些已商业化，而其他一些则处于开发的后期阶段。
