Pumpless extracorporeal removal of carbon dioxide combined with ventilation using low tidal volume and high positive end‐expiratory pressure in a patient with severe acute respiratory distress syndrome

Abstract

The effects of the combination of a ‘lowest’ lung ventilation with extracorporeal elimination of carbon dioxide by interventional lung assist are described in a patient presenting with severe acute respiratory distress syndrome due to fulminant pneumonia. Reducing tidal volume to 3 ml.kg⁻¹ together with interventional lung assist resulted in a decrease in severe hypercapnia without alveolar collapse or hypoxaemia but with a decrease in serum levels of interleukin‐6. This approach was applied for 12 days with recovery of the patient, without complications. Extracorporeal removal of carbon dioxide by interventional lung assist may be a useful tool to enable ‘ultraprotective’ ventilation in severe acute respiratory distress syndrome.