Extracorporeal CO2 Removal Devices: Basics, Indications, and Actual Results

Abstract

Extracorporeal CO₂ removal (ECCO₂R) primarily ensures CO₂ removal, without significant effect on oxygenation. This is possible with low or moderate extracorporeal blood flows unlike ECMO devices. It is important to consider for each ECCO₂R device not only the performance in terms of CO₂ elimination but also the cost and safety, including the incidence of hemorrhagic and thrombotic complications. The most convincing clinical experience has been reported in the context of ARDS and severe acute exacerbations of COPD, particularly in patients at high risk of non invasive ventilation failure. Preliminary reported clinical benefits prompt to achieve in the short term randomized controlled trials in these two major indications.