Extracorporele CO2-verwijdering: nieuwe toepassingen?

The extracorporeal removal of carbon dioxide is an effective technique used to treat patients with acute and severe hypercapnia. The technique has recently been modified from an arterial-venous into a veno-venous one. This modification, which is significant, ensures a safer and easier application of the technique. Furthermore, the flow of blood through the veno-venous system is regulated by roller pumps, making the extracorporeal removal of carbon dioxide possible in haemodynamically unstable patients for the first time. The improved technique can be used together with invasive mechanical ventilation to treat very severe hypercapnia, or for facilitating protective ventilation. In addition, extracorporeal CO₂ removal can be used as an alternative to mechanical ventilation; for example, in patients suffering an exacerbation of COPD. The expansion of indications and the simplified technique make extracorporeal CO₂ removal better and more broadly applicable. This results in new therapeutic options for patients with hypercapnia.

Conflict of interest and financial support: a disclosure form provided by the author is available along with the full text of this article at www.ntvg.nl, search for A5300; click on ‘Belangenverstrengeling’ (‘Conflict of interest’).