• Acta Anaesthesiol Belg · Jan 2012

    Case Reports

    Refractory hypercapnia: a simplified technique for extracorporeal CO2 removal (ECCO2R) in the presence of therapeutic limitations.

    • M Bonnet, X Wittebole, L M Jacquet, and P Hantson.
    • Department of Intensive Care, Cliniques St-Luc, Brussels, Belgium.
    • Acta Anaesthesiol Belg. 2012 Jan 1;63(4):177-80.

    AbstractRefractory hypercapnia with severe acidosis appeared in a 67-year-old man who presented with lung fibrosis and a left pneumothorax as delayed complications of bleomycin chemotherapy for advanced grade lymphoma. Due to failure of noninvasive ventilation using a high-flow nasal cannula oxygen system, the patient was mechanically ventilated with two ventilators at different settings, after intubation with a double-lumen tube. As he had a poor haematological prognosis, extracorporeal membranous oxygenation was not considered. To remove some amount of carbon dioxide, we used a simplified method based on a veno-venous hemofiltration circuit coupled to a paediatric oxygenator and an air/oxygen blender. The efficacy on carbon dioxide removal was modest, with a percentage of CO2 total extraction ranging from 10.5 to 20.4%, but the system was immediately available, well tolerated and not very expensive.

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