Extracorporeal CO2 removal (ECCO2R) in patients with stable COPD with chronic hypercapnia: a proof-of-concept study

Abstract

Domiciliary non-invasive ventilation (NIV) effectively reduces arterial carbon dioxide pressure (PaCO₂) in patients with stable hypercapnic chronic obstructive pulmonary disease, but a consistent percentage of them may remain hypercapnic. We hypothesised that extracorporeal CO₂ removal (ECCO₂R) may lower their PaCO₂. Ten patients hypercapnic despite ≥6 months of NIV underwent a 24-hour trial of ECCO₂R. Six patients completed the ECCO₂R-trial with a PaCO₂ drop ranging between 23% and 47%. Time to return to baseline after interruption ranged 48–96 hours. In four patients, mechanical events led to ECCO₂R premature interruption, despite a decreased in PaCO₂. This time window ‘free’ from hypercapnia might allow to propose the concept of ‘CO₂ dialysis’.