Effects of Extracorporeal CO2 Removal on Inspiratory Effort and Respiratory Pattern in Patients Who Fail Weaning from Mechanical Ventilation

In patients with acute respiratory failure, severe respiratory acidosis is managed by either invasive or noninvasive ventilation (NIV). Recent data suggest that mechanical ventilation may be supported by extracorporeal CO2 removal (ECCO2R) to manage the severe respiratory acidosis consequent to super protective ventilatory strategies in patients with acute respiratory distress syndrome or failure of NIV in patients with acute hypercapnic respiratory failure.This pilot physiological report demonstrates that in patients with chronic obstructive pulmonary disease who are not yet ready to be weaned, the addition of ECCO2R during unsupported breathing avoids the increase in PaCO2 and inspiratory effort and the occurrence of a rapid shallow breathing pattern.We hope these results encourage future investigations on the use ECCO2R to facilitate the weaning process.