Extracorporeal CO2 removal ECCO2R

An extracorporeal veno-venous circulation allows CO2 clearance via a gas exchange membrane. Blood flows of 25-33% cardiac output are typically used which only allow for partial oxygenation support. Low frequency (4-5/min) positive pressure ventilation is usually used with ECCO2R with continuous oxygenation throughout inspiration and expiration. The lungs are 'held open' with high PEEP (20-25cmH2O), limited peak airway pressures (35-40cmH2O) and a continuous fresh gas supply. Thus, oxygenation is effected with lung rest to aid recovery. Anticoagulation of the extracorporeal circuit can be reduced by using heparin-bonded tubing and membranes.

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