When and how can we benefit from applying ECCOR-2? Two case reports

Document Type : Case Report

Authors

1 Department of Anesthesiology and Reanimation, Intensive Care Unit, University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Türkiye.

2 Department of Anesthesiology and Reanimation, Intensive Care Unit, University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Türkiye

3 Department of Anesthesiology and Reanimation, University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Türkiye.

Abstract

Introduction:

Chronic obstructive pulmonary disease (COPD) is a chronic condition characterized by frequent exacerbations, high mortality rates, and significantly reduced quality of life. Cystic fibrosis (CF) is an autosomal recessive disease affecting multiple systems, particularly the respiratory and digestive systems.

Aim:

The extracorporeal carbon dioxide removal system (ECCOR-2) can be utilized in patients with acute hypercapnic respiratory failure who do not respond adequately to mechanical ventilation. The treatment focuses on the patient's carbon dioxide (CO2) and pH levels. ECCOR is indicated for invasive respiratory failure and has been reported to reduce the need for mechanical ventilation support. It also serves as bridge therapy for transplantation candidates, including CF patients.

Discussion:

One of our cases was successfully weaned from invasive support and discharged without ECCOR-related complications. Another patient developed tension pneumothorax due to CF; despite treatment, the patient's condition deteriorated, resulting in death. ECCOR's ability to work alongside venovenous hemofiltration at low flow rates is a significant advantage. Supportive treatment continued post-ECCOR.

Conclusion:

ECCOR-2 effectively removes carbon dioxide and can complement invasive mechanical ventilation (IMV). It facilitated the weaning process in one patient with CO2 levels exceeding 150 mmHg and served as a bridge to transplantation in another.

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