Open AccessExtracorporeal carbon dioxide removal with continuous renal replacement therapy. Case description and literature review
Author(s) -
Maite López-Sánchez,
María Isabel Rubio-López
Publication year - 2020
Publication title -
revista brasileira de terapia intensiva
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.431
H-Index - 19
eISSN - 1982-4335
pISSN - 0103-507X
DOI - 10.5935/0103-507x.20200020
Subject(s) - medicine , extracorporeal membrane oxygenation , cannula , extracorporeal , co2 removal , carbon dioxide , carbon dioxide removal , renal replacement therapy , lung , contraindication , intensive care medicine , respiratory failure , acute respiratory failure , surgery , anesthesia , mechanical ventilation , pathology , ecology , alternative medicine , biology
In recent years and due, in part, to technological advances, the use of extracorporeal carbon dioxide removal systems paired with the use of extracorporeal membrane oxygenation has resurfaced. However, studies are lacking that establish its indications and evidence to support its use. These systems efficiently eliminate carbon dioxide in patients with hypercapnic respiratory failure using small-bore cannula, usually double-lumen cannula with a small membrane lung surface area. Currently, we have several systems with different types of membranes and sizes. Pump-driven veno-venous systems generate fewer complications than do arteriovenous systems. Both require systemic anticoagulation. The "lung-kidney" support system, by combining a removal system with hemofiltration, simultaneously eliminates carbon dioxide and performs continuous extrarenal replacement. We describe our initial experience with a combined system for extracorporeal carbon dioxide removal-continuous extrarenal replacement in a lung transplant patients with hypercapnic respiratory failure, barotrauma and associated acute renal failure. The most important technical aspects, the effectiveness of the system for the elimination of carbon dioxide and a review of the literature are described.