Introduction

Extracorporeal support comprises a variety of techniques. Various acronyms are adopted in the literature to emphasize the main aim of the use of the artificial lung.

1. Extracorporeal membrane oxygenation (ECMO) focuses on the oxygenation aspects of the bypass: it consists of a high-flow venoarterial bypass performed to provide an immediate improvement in the oxygenation of the arterial blood.

2. Extracorporeal CO2 removal (ECCO2R) refers mainly to venovenous bypass at relatively low flow (20-30 per cent of the cardiac output). ECCO 2R is intended to provide lung rest by reducing the ventilation of the diseased lung.

3. Partial extracorporeal CO2 removal (PECO2R) indicates a very low venovenous bypass with partial removal (30-60 per cent) of the CO 2 produced.

4. Extracorporeal lung assist (ECLA) has been proposed in Japan to emphasize both the oxygenation and ventilatory functions of the extracorporeal support.

Whatever terminology is used, a correct description of the system should include the type of bypass (venoarterial or venovenous), the ratio of extracorporeal blood flow to cardiac output, and the ventilatory management of the natural lungs (low-frequency high-frequency jet ventilation, continuous positive-pressure ventilation, continuous positive airway pressure, etc.).

Here, we focus on the technique of low-frequency positive-pressure ventilation with extracorporeal CO 2 removal (LFPPV-ECCO2R), covering the rationale, method, and clinical experience gained by our group over the last 20 years.

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Sleep Apnea

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