LOW BLOOD-FLOW EXTRACORPOREAL CARBON-DIOXIDE REMOVAL (ECCO(2)R) - A REVIEW OF THE CONCEPT AND A CASE-REPORT

Despite advances in respiratory and critical care medicine, the mortal ity from ARDS remains unchanged. Recent research suggests current vent ilatory therapy may produce additional lung injury, retarding the reco very process of the lung. Alternative supportive therapies, such as EC MO and ECCO(2)R, ultimately may result in less ventilator induced lung injury. Due to the invasiveness of ECMO/ECCO(2)R, these modalities ar e initiated reluctantly and commonly not until patients suffer from te rminal or near-terminal respiratory failure. Low flow ECCO(2)R may off er advantages of less invasiveness and be suitable for early instituti on before ARDS becomes irreversible. We describe a patient with ARDS a nd severe macroscopic barotrauma supported with low flow ECCO(2)R resu lting in significant CO2 clearance, reduction of peak, mean airway pre ssures and minute ventilation.