Department of Anesthesia and Intensive Care Medicine, Sapienza University di Rome, Policlinico Umberto I, Rome, Italy.
Curr Opin Crit Care. 2018 Feb;24(1):29-34. doi: 10.1097/MCC.0000000000000471.
Aim of this article is to review evidence recently generated on the application of extracorporeal carbon dioxide removal (ECCO2R) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) requiring mechanical ventilation (invasive and non invasive) for hypercapnic respiratory failure.
To date, the paucity of evidences on ECCO2R to decrease the rate of noninvasive ventilation (NIV) failure and to wean hypercapnic patients from invasive mechanical ventilation (IMV) precludes to systematically apply this technology to COPD patients.
Although several efforts have been made to reduce invasiveness and to improve the efficiency of extracorporeal systems, further randomized studies are needed to assess the effects of this technique on both short-term and long-term clinical outcomes.
本文旨在回顾最近在体外二氧化碳去除（ECCO2R）应用方面产生的证据，这些证据涉及需要机械通气（有创和无创）治疗高碳酸血症呼吸衰竭的慢性阻塞性肺疾病（COPD）急性加重患者。
迄今为止，ECCO2R 降低无创通气（NIV）失败率和使高碳酸血症患者脱离有创机械通气（IMV）的证据不足，这使得无法将这项技术系统地应用于 COPD 患者。
尽管已经做出了一些努力来降低侵入性并提高体外系统的效率，但仍需要进一步的随机研究来评估这项技术对短期和长期临床结局的影响。
