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Physiological and Technical Considerations of Extracorporeal CO2 Removal

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Annual Update in Intensive Care and Emergency Medicine 2019

Part of the book series: Annual Update in Intensive Care and Emergency Medicine ((AUICEM))

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Abstract

Extracorporeal systems are increasingly used in severe hypoxemic and/or hypercapnic respiratory failure [1]. Although recent data have shown an advantage of high-flow veno-venous extracorporeal membrane oxygenation (VV-ECMO) in severe acute respiratory distress syndrome (ARDS) [2, 3], there is a paucity of evidence regarding the utility of extracorporeal CO2 removal (ECCO2R, often similarly used: low-flow ECMO) in patients with respiratory failure. Despite this fact, the number of available systems is dramatically increasing. In this chapter, we therefore provide an overview of the currently used technologies with advantages and disadvantages in the light of physiology.

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Acknowledgements

We are grateful to Sascha Groß-Hardt, Institute of Applied Medical Engineering, Helmholtz Institute Aachen, RWTH Aachen University, Germany for his contribution to the current work. The current work was supported by the German Federal Ministry of Education and Research (13GW0219B; Verbundprojekt tragbare Langzeitunterstützung der Lunge zur Behandlung der schweren COPD [p-ECCO2R]).

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Authors and Affiliations

  1. Department of Pneumology and Critical Care Medicine, Cologne-Merheim Hospital, ARDS and ECMO Centre, Witten/Herdecke University Hospital, Cologne, Germany

    C. Karagiannidis

  2. Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute Aachen, RWTH Aachen University, Aachen, Germany

    F. Hesselmann

  3. Interdepartmental Division of Critical Care Medicine, University of Toronto and the Extracorporeal Life Support Program, Toronto General Hospital, Toronto, Canada

    E. Fan

Authors
  1. C. Karagiannidis
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  2. F. Hesselmann
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  3. E. Fan
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Correspondence to C. Karagiannidis .

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Editors and Affiliations

  1. Dept. of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium

    Jean-Louis Vincent

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Karagiannidis, C., Hesselmann, F., Fan, E. (2019). Physiological and Technical Considerations of Extracorporeal CO2 Removal. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2019. Annual Update in Intensive Care and Emergency Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-06067-1_8

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  • DOI: https://doi.org/10.1007/978-3-030-06067-1_8

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-06066-4

  • Online ISBN: 978-3-030-06067-1

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