体外二氧化碳去除技术的研究进展

王筱鑫; 郭艳

doi:10.7499/j.issn.1008-8830.2208187

PDF(523 KB)

HTML

中国当代儿科杂志 ›› 2023, Vol. 25 ›› Issue (2) : 205-209. DOI: 10.7499/j.issn.1008-8830.2208187

综述

体外二氧化碳去除技术的研究进展

王筱鑫, 郭艳

作者信息 +

Recent research on extracorporeal carbon dioxide removal

WANG Xiao-Xin, GUO Yan

Author information +

文章历史 +

摘要

体外二氧化碳去除技术是基于肺外气体交换的人工肺辅助技术，可有效清除二氧化碳，并提供有限的氧合，是近年来继机械通气、体外膜肺氧合等技术之后发展起来的治疗高碳酸血症的有效技术之一，具有广泛的应用前景。该文具体阐述体外二氧化碳去除技术的发展、工作原理及优势、分类、并发症及临床应用等，旨在为临床上进行体外二氧化碳去除提供一种新选择。

Abstract

Extracorporeal carbon dioxide removal is an artificial lung auxiliary technique based on extrapulmonary gas exchange and can effectively remove carbon dioxide and provide oxygenation to a certain extent, and it is one of the effective treatment techniques for hypercapnia developed after mechanical ventilation and extracorporeal membrane oxygenation in recent years and has wide application prospect. This article elaborates on the development, working principle, advantages, classification, complications, and clinical application of extracorporeal carbon dioxide removal, so as to provide a new choice for extracorporeal carbon dioxide removal in clinical practice.

导出引用

王筱鑫, 郭艳. 体外二氧化碳去除技术的研究进展[J]. 中国当代儿科杂志. 2023, 25(2): 205-209 https://doi.org/10.7499/j.issn.1008-8830.2208187

WANG Xiao-Xin, GUO Yan. Recent research on extracorporeal carbon dioxide removal[J]. Chinese Journal of Contemporary Pediatrics. 2023, 25(2): 205-209 https://doi.org/10.7499/j.issn.1008-8830.2208187

参考文献

1 倪虹, 刘海鹏, 崔伟, 等. 安徽某医院2013-2017年住院儿童疾病谱变化研究[J]. 中华疾病控制杂志, 2019, 23(2): 237-240. DOI: 10.16462/j.cnki.zhjbkz.2019.02.023.
2 Husain-Syed F, Birk HW, Wilhelm J, et al. Extracorporeal carbon dioxide removal using a renal replacement therapy platform to enhance lung-protective ventilation in hypercapnic patients with coronavirus disease 2019-associated acute respiratory distress syndrome[J]. Front Med (Lausanne), 2020, 7: 598379. PMID: 33304914. PMCID: PMC7693445. DOI: 10.3389/fmed.2020.598379.
3 Ding X, Chen H, Zhao H, et al. ECCO2R in 12 COVID-19 ARDS patients with extremely low compliance and refractory hypercapnia[J]. Front Med (Lausanne), 2021, 8: 654658. PMID: 34307397. PMCID: PMC8295461. DOI: 10.3389/fmed.2021.654658.
4 Kolobow T, Gattinoni L, Tomlinson T, et al. An alternative to breathing[J]. J Thorac Cardiovasc Surg, 1978, 75(2): 261-266. PMID: 625133.
5 Bozku? F, Bilal B, ?ksüz H. Extracorporeal carbondioxide removal (ECCO2R): case series and review of literature[J]. Tuberk Toraks, 2018, 66(3): 258-265. PMID: 30479235. DOI: 10.5578/tt.26368.
6 Mussin Y, Jeffries R, Bulanin D, et al. Pre-clinical evaluation of an adult extracoproreal carbon dioxide removal system for pediatric application[J]. Cent Asian J Glob Health, 2014, 3(Suppl): 167. PMID: 29805896. PMCID: PMC5960935. DOI: 10.5195/cajgh.2014.167.
7 Giraud R, Banfi C, Assouline B, et al. The use of extracorporeal CO2 removal in acute respiratory failure[J]. Ann Intensive Care, 2021, 11(1): 43. PMID: 33709318. PMCID: PMC7951130. DOI: 10.1186/s13613-021-00824-6.
8 Wrisinger WC, Thompson SL. Basics of extracorporeal membrane oxygenation[J]. Surg Clin North Am, 2022, 102(1): 23-35. PMID: 34800387. PMCID: PMC8598290. DOI: 10.1016/j.suc.2021.09.001.
9 Ficial B, Vasques F, Zhang J, et al. Physiological basis of extracorporeal membrane oxygenation and extracorporeal carbon dioxide removal in respiratory failure[J]. Membranes (Basel), 2021, 11(3): 225. PMID: 33810130. PMCID: PMC8004966. DOI: 10.3390/membranes11030225.
10 Chang BY, Keller SP. Dual carbon dioxide capture to achieve highly efficient ultra-low blood flow extracorporeal carbon dioxide removal[J]. Ann Biomed Eng, 2020, 48(5): 1562-1572. PMID: 32072384. PMCID: PMC7323891. DOI: 10.1007/s10439-020-02477-1.
11 Stokes JW, Gannon WD, Rice TW. Extracorporeal carbon dioxide removal or extracorporeal membrane oxygenation: why should we care?[J]. Crit Care Med, 2021, 49(5): e546-e547. PMID: 33854019. DOI: 10.1097/CCM.0000000000004844.
12 López-Sánchez M, Rubio-López MI. Extracorporeal carbon dioxide removal with continuous renal replacement therapy. Case description and literature review[J]. Rev Bras Ter Intensiva, 2020, 32(1): 143-148. PMID: 32401973. PMCID: PMC7206950. DOI: 10.5935/0103-507x.20200020.
13 Walter JM, Corbridge TC, Singer BD. Invasive mechanical ventilation[J]. South Med J, 2018, 111(12): 746-753. PMID: 30512128. PMCID: PMC6284234. DOI: 10.14423/SMJ.0000000000000905.
14 Comellini V, Pacilli AMG, Nava S. Benefits of non-invasive ventilation in acute hypercapnic respiratory failure[J]. Respirology, 2019, 24(4): 308-317. PMID: 30636373. DOI: 10.1111/resp.13469.
15 Nin N, Muriel A, Pe?uelas O, et al. Severe hypercapnia and outcome of mechanically ventilated patients with moderate or severe acute respiratory distress syndrome[J]. Intensive Care Med, 2017, 43(2): 200-208. PMID: 28108768. PMCID: PMC5630225. DOI: 10.1007/s00134-016-4611-1.
16 Morales-Quinteros L, Del Sorbo L, Artigas A. Extracorporeal carbon dioxide removal for acute hypercapnic respiratory failure[J]. Ann Intensive Care, 2019, 9(1): 79. PMID: 31267300. PMCID: PMC6606679. DOI: 10.1186/s13613-019-0551-6.
17 侯陈玮, 黑飞龙. 体外二氧化碳去除技术在呼吸系统危重症患者中的应用[J]. 中国体外循环杂志, 2018, 16(1): 56-58. DOI: 10.13498/j.cnki.chin.j.ecc.2018.01.14.
18 Cove ME, MacLaren G, Federspiel WJ, et al. Bench to bedside review: extracorporeal carbon dioxide removal, past present and future[J]. Crit Care, 2012, 16(5): 232. PMID: 23014710. PMCID: PMC3682237. DOI: 10.1186/cc11356.
19 Staudinger T. Update on extracorporeal carbon dioxide removal: a comprehensive review on principles, indications, efficiency, and complications[J]. Perfusion, 2020, 35(6): 492-508. PMID: 32156179. DOI: 10.1177/0267659120906048.
20 Kischkel S, Bergt S, Brock B, et al. In vivo testing of extracorporeal membrane ventilators: iLA-activve versus prototype I-lung[J]. ASAIO J, 2017, 63(2): 185-192. PMID: 28092273. DOI: 10.1097/MAT.0000000000000465.
21 Saavedra-Romero R, Paz F, Litell JM, et al. Treatment of severe hypercapnic respiratory failure caused by SARS-CoV-2 lung injury with ECCO2R using the Hemolung Respiratory Assist System[J]. Case Rep Crit Care, 2021, 2021: 9958343. PMID: 34327027. PMCID: PMC8245249. DOI: 10.1155/2021/9958343.
22 ?nal V, Efe S. Extracorporeal carbon dioxide removal (ECCO2R) in COPD and ARDS patients with severe hypercapnic respiratory failure. A retrospective case-control study[J]. Turk J Med Sci, 2021, 51(4): 2127-2135. PMID: 33932971. PMCID: PMC8569780. DOI: 10.3906/sag-2012-151.
23 Braune S, Sieweke A, Brettner F, et al. The feasibility and safety of extracorporeal carbon dioxide removal to avoid intubation in patients with COPD unresponsive to noninvasive ventilation for acute hypercapnic respiratory failure (ECLAIR study): multicentre case-control study[J]. Intensive Care Med, 2016, 42(9): 1437-1444. PMID: 27456703. DOI: 10.1007/s00134-016-4452-y.
24 McNamee JJ, Gillies MA, Barrett NA, et al. Effect of lower tidal volume ventilation facilitated by extracorporeal carbon dioxide removal vs standard care ventilation on 90-day mortality in patients with acute hypoxemic respiratory failure: the REST randomized clinical trial[J]. JAMA, 2021, 326(11): 1013-1023. PMID: 34463700. PMCID: PMC8408762. DOI: 10.1001/jama.2021.13374.
25 Barrett NA, Kostakou E, Hart N, et al. Extracorporeal carbon dioxide removal for acute hypercapnic exacerbations of chronic obstructive pulmonary disease: study protocol for a randomised controlled trial[J]. Trials, 2019, 20(1): 465. PMID: 31362776. PMCID: PMC6664508. DOI: 10.1186/s13063-019-3548-4.
26 MacDonnell KF, Moon HS, Sekar TS, et al. Extracorporeal membrane oxygenator support in a case of severe status asthmaticus[J]. Ann Thorac Surg, 1981, 31(2): 171-175. PMID: 7458488. DOI: 10.1016/s0003-4975(10)61538-x.
27 Schneider TM, Bence T, Brettner F. "Awake" ECCO2R superseded intubation in a near-fatal asthma attack[J]. J Intensive Care, 2017, 5: 53. PMID: 28808576. PMCID: PMC5549394. DOI: 10.1186/s40560-017-0247-7.
28 Esposito R, Esposito I, Imperatore F, et al. Decapneization as supportive therapy for the treatment of status asthmaticus: a case report[J]. J Med Case Rep, 2021, 15(1): 200. PMID: 33853666. PMCID: PMC8045444. DOI: 10.1186/s13256-021-02689-6.
29 Fuehner T, Kuehn C, Hadem J, et al. Extracorporeal membrane oxygenation in awake patients as bridge to lung transplantation[J]. Am J Respir Crit Care Med, 2012, 185(7): 763-768. PMID: 22268135. DOI: 10.1164/rccm.201109-1599OC.
30 Hoetzenecker K, Donahoe L, Yeung JC, et al. Extracorporeal life support as a bridge to lung transplantation-experience of a high-volume transplant center[J]. J Thorac Cardiovasc Surg, 2018, 155(3): 1316-1328.e1. PMID: 29248282. DOI: 10.1016/j.jtcvs.2017.09.161.
31 Moscatelli A, Ottonello G, Nahum L, et al. Noninvasive ventilation and low-flow veno-venous extracorporeal carbon dioxide removal as a bridge to lung transplantation in a child with refractory hypercapnic respiratory failure due to bronchiolitis obliterans[J]. Pediatr Crit Care Med, 2010, 11(1): e8-e12. PMID: 20051789. DOI: 10.1097/PCC.0b013e3181b0123b.
32 Wong SK, Chim M, Allen J, et al. Carbon dioxide levels in neonates: what are safe parameters?[J]. Pediatr Res, 2022, 91(5): 1049-1056. PMID: 34230621. PMCID: PMC9122818. DOI: 10.1038/s41390-021-01473-y.
33 Fletcher K, Chapman R, Keene S. An overview of medical ECMO for neonates[J]. Semin Perinatol, 2018, 42(2): 68-79. PMID: 29336834. DOI: 10.1053/j.semperi.2017.12.002.
34 Conrad SA. Extracorporeal carbon dioxide removal: from bench to bedside and back[J]. Crit Care Med, 2020, 48(12): 1924-1925. PMID: 33255119. DOI: 10.1097/CCM.0000000000004646.