Extracorporeal carbon dioxide removal (ECCO2R) in COPD and ARDS patients with severe hypercapnic respiratory failure. A retrospective case-control study

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dc.authoridinal, volkan/0000-0003-2649-104X
dc.authoridEfe, Serdar/0000-0002-1229-0602
dc.authorwosidEfe, Serdar/JAN-4839-2023
dc.authorwosidinal, volkan/A-6069-2018
dc.authorwosidEfe, Serdar/R-8350-2017
dc.contributor.authorInal, Volkan
dc.contributor.authorEfe, Serdar
dc.date.accessioned2024-06-12T11:01:39Z
dc.date.available2024-06-12T11:01:39Z
dc.date.issued2021
dc.departmentTrakya Üniversitesien_US
dc.description.abstractBackground/aim: Treatment of severe hypercapnic respiratory failure (HRF) has some challenges in patients with chronic obstructive pulmonary disease (COPD) and acute respiratory distress syndrome (ARDS), especially when lung protective ventilation (LPV) strategies are required. Extracorporeal CO2 removal (ECCO2R) therapy is an emerging option to manage hypercapnia while allowing LPV in these cases. However, further data on ECCO2R use is still needed to make clear recommendations. Materials and methods: This study was conducted on patients admitted to intensive care unit (ICU) between January 1st, 2016 to December 31st, 2019. The medical records were retrospectively scanned in institutional software database. Patients who received invasive mechanic ventilation (iMV) support due to severe HRF related to COPD or ARDS were included in the analyses. Patients were grouped according to treatment approaches as that ECCO2R therapy in addition to conventional treatments and conventional treatments alone (controls). Groups were compared for 28-day survival, iMV duration, and length of stay (LOS). Results: ECCO2R therapy was noted in 75 of the cases among included 395 patients (COPD n = 256, ARDS n = 139) out of scanned 1715 medical records. The survival rate of ECCO2R patients was 68% and significantly higher than 58% survival rate of controls (p = 0.025), with relative risk reduction (RRR) = 0.16, absolute risk reduction (ARR)= 0.10, number need to treat (NNT) = 10, and odds ratio (OR) = 1.5. In addition, iMV duration (12.8 +/- 2.6 vs. 17.1 +/- 4.9 days, p = 0.007) and LOS (16.9 +/- 4.1 vs. 18.9 +/- 5.5 days, p = 0.032) were significantly shorter than controls. Repeated measure analyses showed that LPV settings were successfully provided by 72 h of ECCO2R therapy. Subgroup analyses according to diagnoses of COPD and ARDS also favored ECCO2R. Conclusion: ECCO2R therapy significantly improved survival, iMV duration and LOS in patients with severe HRF due to COPD or ARDS, and successfully provided LPV approaches. Further studies are needed to assess promising benefits of ECCO2R therapy.en_US
dc.identifier.doi10.3906/sag-2012-151
dc.identifier.endpage2135en_US
dc.identifier.issn1300-0144
dc.identifier.issn1303-6165
dc.identifier.issue4en_US
dc.identifier.pmid33932971en_US
dc.identifier.scopus2-s2.0-85114235796en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpage2127en_US
dc.identifier.trdizinid481007en_US
dc.identifier.urihttps://doi.org/10.3906/sag-2012-151
dc.identifier.urihttps://search.trdizin.gov.tr/yayin/detay/481007
dc.identifier.urihttps://hdl.handle.net/20.500.14551/20982
dc.identifier.volume51en_US
dc.identifier.wosWOS:000691664800005en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakTR-Dizinen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherTubitak Scientific & Technological Research Council Turkeyen_US
dc.relation.ispartofTurkish Journal Of Medical Sciencesen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectExtracorporeal Carbon Dioxide Removalen_US
dc.subjectECCO2Ren_US
dc.subjectHypercapnic Respiratory Failureen_US
dc.subjectArtificial Membranesen_US
dc.subjectSurvivalen_US
dc.subjectIntensive Careen_US
dc.subjectCo2 Removalen_US
dc.subjectMembrane-Oxygenationen_US
dc.titleExtracorporeal carbon dioxide removal (ECCO2R) in COPD and ARDS patients with severe hypercapnic respiratory failure. A retrospective case-control studyen_US
dc.typeArticleen_US

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