Erschienen in:
15.10.2018 | Understanding the Disease
Understanding hypoxemia on ECCO2R: back to the alveolar gas equation
verfasst von:
Jean-Luc Diehl, Alain Mercat, Antonio Pesenti
Erschienen in:
Intensive Care Medicine
|
Ausgabe 2/2019
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Excerpt
Extracorporeal CO
2 removal (ECCO
2R) is a promising technique for ARDS and for severe acute exacerbations of COPD [
1]. However, ECCO
2R carries its own risk of complications and side effects. Beyond hemorrhagic and thrombotic complications and hemolysis, the occurrence of progressive hypoxemia has been reported in COPD patients treated by ECCO
2R, leading to a tracheal intubation rate of 28% in the prospective series from Braune et al. [
2]. Obviously, progressive hypoxemia can be explained by pulmonary complications such as evolving infiltrates, even if other factors such as modification of the respiratory quotient have been proposed [
2,
3]. Accordingly, we illustrate such a mechanism, intrinsically linked to the ECCO
2R technique and not involving any worsening of lung function by itself. …
