{"title":"ECCO2R案例研究","authors":"Marlice van Dyk","doi":"10.1016/j.ejccm.2018.12.016","DOIUrl":null,"url":null,"abstract":"<div><p>Hypercapnic respiratory failure is common in ICU due to ARDS and COPD exacerbations. The use of ECCO2R has changed the way we manage these patients. We report a patient with COPD exacerbation that failed NIV and placed on low flow ECCO2R. Low flow ECCO2R does not support oxygenation and only clears a proportion of the CO2 produced.</p><p>Presentation of the case: a 64 y old women with severe COPD who failed NIV was placed on ECCO2R with the Hemolung system. The severe respiratory acidosis cleared and intubation was avoided. After a few days, she became more hypoxic, and the decision was made not to intubate this patient.</p><p>There is increased CO<sub>2</sub> production and decreased clearance of CO<sub>2</sub> during COPD exacerbation. ECCO<sub>2</sub>R has been shown to improve mortality and decrease the need for intubation. There are various ECCO<sub>2</sub>R systems on the market with different flows and differently sized oxygenators.</p><p>The use of ECCO<sub>2</sub>R in selected patients is a promising add-on to conventional management of these patients. The difficulty in predicting the progression of the disease will always be a challenge. Extracorporeal therapies should be performed in centres that are experienced in the management of these patients.</p></div>","PeriodicalId":31233,"journal":{"name":"Egyptian Journal of Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.3000,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejccm.2018.12.016","citationCount":"0","resultStr":"{\"title\":\"ECCO2R case study\",\"authors\":\"Marlice van Dyk\",\"doi\":\"10.1016/j.ejccm.2018.12.016\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>Hypercapnic respiratory failure is common in ICU due to ARDS and COPD exacerbations. The use of ECCO2R has changed the way we manage these patients. We report a patient with COPD exacerbation that failed NIV and placed on low flow ECCO2R. Low flow ECCO2R does not support oxygenation and only clears a proportion of the CO2 produced.</p><p>Presentation of the case: a 64 y old women with severe COPD who failed NIV was placed on ECCO2R with the Hemolung system. The severe respiratory acidosis cleared and intubation was avoided. After a few days, she became more hypoxic, and the decision was made not to intubate this patient.</p><p>There is increased CO<sub>2</sub> production and decreased clearance of CO<sub>2</sub> during COPD exacerbation. ECCO<sub>2</sub>R has been shown to improve mortality and decrease the need for intubation. There are various ECCO<sub>2</sub>R systems on the market with different flows and differently sized oxygenators.</p><p>The use of ECCO<sub>2</sub>R in selected patients is a promising add-on to conventional management of these patients. The difficulty in predicting the progression of the disease will always be a challenge. Extracorporeal therapies should be performed in centres that are experienced in the management of these patients.</p></div>\",\"PeriodicalId\":31233,\"journal\":{\"name\":\"Egyptian Journal of Critical Care Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.3000,\"publicationDate\":\"2018-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.ejccm.2018.12.016\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Egyptian Journal of Critical Care Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2090730318300537\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Egyptian Journal of Critical Care Medicine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2090730318300537","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
Hypercapnic respiratory failure is common in ICU due to ARDS and COPD exacerbations. The use of ECCO2R has changed the way we manage these patients. We report a patient with COPD exacerbation that failed NIV and placed on low flow ECCO2R. Low flow ECCO2R does not support oxygenation and only clears a proportion of the CO2 produced.
Presentation of the case: a 64 y old women with severe COPD who failed NIV was placed on ECCO2R with the Hemolung system. The severe respiratory acidosis cleared and intubation was avoided. After a few days, she became more hypoxic, and the decision was made not to intubate this patient.
There is increased CO2 production and decreased clearance of CO2 during COPD exacerbation. ECCO2R has been shown to improve mortality and decrease the need for intubation. There are various ECCO2R systems on the market with different flows and differently sized oxygenators.
The use of ECCO2R in selected patients is a promising add-on to conventional management of these patients. The difficulty in predicting the progression of the disease will always be a challenge. Extracorporeal therapies should be performed in centres that are experienced in the management of these patients.
期刊介绍：
The Egyptian Journal of Critical Care Medicine is the official Journal of the Egyptian College of Critical Care Physicians, the most authoritative organization of Egyptian physicians involved in the multi-professional field of critical care medicine. The journal is intended to provide a peer-reviewed source for multidisciplinary coverage of general acute and intensive care medicine and its various subcategories including cardiac, pulmonary, neuro, renal as well as post-operative care. The journal is proud to have an international multi-professional editorial board in the broad field of critical care that will assist in publishing promising research and breakthrough reports that lead to better patients care in life threatening conditions, and bring the reader a quick access to the latest diagnostic and therapeutic approaches in monitoring and management of critically ill patients.
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