A case of switching from long-term veno venous ECMO to extracorporeal CO<sub>2</sub> removal (ECCO<sub>2</sub>R) using a dialysis catheter and centrifugal pump

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Other Title
  • 長期veno venous ECMOから透析用カテーテルと遠心ポンプを用いたextracorporeal CO<sub>2</sub> removal（ECCO<sub>2</sub>R）に移行した一例
Published
2022-11-01
DOI
  • 10.3918/jsicm.29_580
Publisher
The Japanese Society of Intensive Care Medicine

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<p>A 58-year-old man with severe coronavirus disease and acute respiratory distress syndrome received mechanical ventilation and veno venous extracorporeal membrane oxygenation (ECMO). After long-term ECMO management, oxygenation improved; however, his lung compliance remained poor and persistent bacteremia was refractory to treatment. In order to reduce the cannulation sites and promote rehabilitation, his ECMO was switched to extracorporeal carbon dioxide removal (ECCO2R) using a dialysis catheter and centrifugal pump on day 98. The decrease in minute ventilation and esophageal pressure swings suggested that ECCO2R reduced respiratory effort and allowed for a lung protective ventilation strategy. ECCO2R aims to eliminate blood CO2, but there is no dedicated device in Japan. In this case, ECCO2R using a dialysis catheter and centrifugal pump was safely performed. Although there is no clear indication for ECCO2R, it may be effective in cases of difficult weaning after long-term ECMO.</p>

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