RT Journal Article SR Electronic T1 Treatment of hypercapnic respiratory failure with a novel extracorporeal CO2 removal system JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 392 VO 40 IS Suppl 56 A1 Nausherwan Burki A1 Raj Mani A1 Felix Herth A1 Werner Schmidt A1 Helmut Teschler A1 Frank Bonin A1 Heinrich Becker A1 Winfried Randerath A1 Sven Stieglitz A1 Lars Hagmeyer A1 Christina Priegnitz A1 Michael Pfeifer A1 Stefan Blaas A1 Christian Putensen A1 Nils Theuerkauf A1 Michael Quintel A1 Onnen Moerer YR 2012 UL http://erj.ersjournals.com/content/40/Suppl_56/392.abstract AB Background: Extracorporeal CO2 removal (ECCO2R), a potentially valuable technique, has not been systematically evaluated in patients with hypercapnic respiratory failure. We describe the application of a novel single venous catheter, low blood flow, ECCO2R device (Hemolung® Respiratory Assist System, ALung Technologies, Inc.).Methods: Twenty three hypercapnic patients received ECCO2R. Group 1 (n=7) consisted of patients with chronic obstructive lung disease on noninvasive ventilation with a high likelihood of requiring invasive ventilation, Group 2 (n=2) were patients who could not be weaned from noninvasive ventilation, Group 3 (n=11) were patients who could not be weaned from invasive ventilation, and Group 4 (n=3) were patients on invasive ventilation requiring lung protective ventilation techniques.Results: The device was well tolerated, with complications and rates similar to those seen with central venous catheterization. Blood flow through the system was 430.5±73.7 ml/min, and ECCO2R was 82.5±15.6 ml/min. Invasive ventilation was avoided in all patients in Group 1 and both patients in Group 2 were weaned; PaCO2 decreased significantly (p<0.003) with application of the device. In Group 3, three patients were weaned, in 3 patients ventilatory support was reduced, and one patient died due to a retroperitoneal bleed following catheterization. In Group 4, lung protective ventilation was enhanced by the ECCO2R device.Conclusions: This single catheter, low blood flow ECCO2R system provided clinically useful levels of CO2 removal in these hypercapnic patients. The system appears to be a potentially valuable additional modality for the treatment of hypercapnic respiratory failure.