[Extracorporeal CO2 removal as an alternative to tracheotomy in a patient with extubation failure]

Anaesthesist. 2016 Dec;65(12):925-928. doi: 10.1007/s00101-016-0244-6. Epub 2016 Nov 28.
[Article in German]

Abstract

We report a patient with chest trauma who was admitted to the ICU after surgery. As he fulfilled protocol-based criteria, he was extubated 7 days after admission. However, despite intermittent non-invasive ventilation, the patient had to be re-intubated on day 10 owing to progressive hypercapnia. We decided to support the patient with a mid-flow veno-venous extracorporeal carbon dioxide removal (ECCO2‑R) system instead of a tracheotomy. Sufficient CO2 removal was established with a blood flow of 1.5 l/min and the patient was successfully extubated within a few hours. After 5 days of ECCO2‑R the patient could be weaned and transferred to a general ward in a stable condition.

Keywords: Extracorporeal CO2 removal; Hypercapnia; Intensive care medicine; Tracheotomy; Veno-venous ECMO.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Airway Extubation / methods*
  • Carbon Dioxide / blood*
  • Extracorporeal Circulation
  • Extracorporeal Membrane Oxygenation / methods*
  • Humans
  • Hypercapnia / therapy*
  • Male
  • Noninvasive Ventilation
  • Tracheotomy / methods*
  • Treatment Failure
  • Treatment Outcome

Substances

  • Carbon Dioxide