Lund Laura W, Federspiel William J
ALung Technologies, Inc, 2500 Jane Street, Suite 1, Pittsburgh, PA 15203.
Curr Respir Care Rep. 2013 Jun 28;2(3):131-138. doi: 10.1007/s13665-013-0057-x. Print 2013.
For patients experiencing acute respiratory failure due to a severe exacerbation of chronic obstructive pulmonary disease (COPD), noninvasive positive pressure ventilation has been shown to significantly reduce mortality and hospital length of stay compared to respiratory support with invasive mechanical ventilation. Despite continued improvements in the administration of noninvasive ventilation (NIV), refractory hypercapnia and hypercapnic acidosis continue to prevent its successful use in many patients. Recent advances in extracorporeal gas exchange technology have led to the development of systems designed to be safer and simpler by focusing on the clinical benefits of partial extracorporeal carbon dioxide removal (ECCOR), as opposed to full cardiopulmonary support. While the use of ECCOR has been studied in the treatment of acute respiratory distress syndrome (ARDS), its use for acute hypercapnic respiratory during COPD exacerbations has not been evaluated until recently. This review will focus on literature published over the last year on the use of ECCOR for removing extra CO in patients experiencing an acute exacerbation of COPD.
对于因慢性阻塞性肺疾病(COPD)严重加重而出现急性呼吸衰竭的患者,与有创机械通气的呼吸支持相比,无创正压通气已被证明可显著降低死亡率和缩短住院时间。尽管无创通气(NIV)的应用持续改进,但难治性高碳酸血症和高碳酸血症性酸中毒仍妨碍其在许多患者中的成功应用。体外气体交换技术的最新进展促使开发了一些系统,这些系统通过关注部分体外二氧化碳清除(ECCOR)的临床益处而设计得更安全、更简单,而非全心肺支持。虽然ECCOR在急性呼吸窘迫综合征(ARDS)治疗中的应用已得到研究,但直到最近其在COPD加重期急性高碳酸血症呼吸中的应用才得到评估。本综述将聚焦过去一年发表的关于ECCOR用于清除COPD急性加重患者体内多余二氧化碳的文献。