Introduction: Extracorporeal CO 2 elimination (ECCO 2 R) is an integral part of modern intensive care medicine.It can be used to reduce the carbon dioxide (CO 2 ) content in the blood and, consequently, potentially lower the risk of ventilation-induced lung damage.The aim of the study was to investigate the safety and effectiveness of the multi-ECCO2R gas exchanger in patients with combined renal insufficiency and hypercapnia due to acute lung failure.Methods: In this multicenter, prospective, interventional study, 28 patients were recruited and treated for up to 72 hours on the multiFiltrate (MFT)/MFT PRO with the multiECCO 2 R gas exchanger under citrate or heparin anticoagulation.The clinical objective was to demonstrate that combined CVVHD/CVVHDF and multiECCO 2 R treatment can reduce respiratory acidosis and the need for ventilation in patients with concomitant renal failure.The technical objective was to investigate how much CO 2 can be eliminated by the multiECCO2R gas exchanger in extracorporeal circulation.Study-specific parameters were documented at baseline and throughout the course of the treatment.Results: A total of 28 patients were included in the study.Among them, 18 patients received citrate anticoagulation and are presented here as preliminary data, while 10 patients received heparin anticoagulation and will be reported in the comprehensive study publication.The primary cause of acute renal failure (AKI stage 3, 100%) was sepsis (47.4%), and the primary cause of pulmonary failure was pneumonia (73.7%),SOFA score 13.5 2.8.The results showed a significant reduction in paCO 2 values from 56.59 6.98 mmHg (start of treatment) to 42.90 7.21 mmHg (after 72 h; p=0.0028) with constant ventilation parameters and improved pH values (7.30 0.07 -7.43 0.06; p=0.0226).Protective ventilation was ensured by an inspiratory pressure difference (driving pressure) of 16 4 mbar and a tidal volume of 5 1.3 mL/kg PBW (predicted body weight).Despite the maximum blood flow of 200 ml/min with citrate anticoagulation, the treatment resulted in a significant paCO 2 reduction.PCO 2 was 49 9.8 mmHg before and 7 3.4 mmHg after the gas exchanger (start of treatment), and the calculated CO 2 elimination remained largely constant over time.
Jiang et al. (Wed,) studied this question.