SynthesisIntensive care medicine2015
Extracorporeal carbon dioxide removal in patients with chronic obstructive pulmonary disease: a systematic review.
Synthesis in Intensive care medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
42 citing papers in PubMed, 3 syntheses or guidelines pooled it, 113 citations in OpenAlex.
- Effects of extracorporeal COCritical care (London, England) · 2024Pooled it
- Extracorporeal carbon dioxide removal for patients with acute respiratory failure: a systematic review and meta-analysis.Annals of medicine · 2023Pooled it
- Mechanical Ventilation and Extracorporeal Membrane Oxygena tion in Acute Respiratory Insufficiency.Deutsches Arzteblatt international · 2018Guideline
- High-Caliber Femoral Dual-Lumen Cannula for ECCO 2 R in Hypercapnic Respiratory Failure: Efficacy and Safety Evaluation.ASAIO journal (American Society for Artificial Internal Organs : 1992) · 2026Article
- Article
- The role of extracorporeal COFrontiers in medicine · 2025Review
- Feasibility and safety of ultra-low volume ventilation (≤ 3 ml/kg) combined with extra corporeal carbon dioxide removal (ECCOCritical care (London, England) · 2024Article
- Extracorporeal Carbon Dioxide Removal in Chronic Obstructive Pulmonary Disease: It Depends on the Objective!American journal of respiratory and critical care medicine · 2024Article
- Current knowledge gaps in extracorporeal respiratory support.Intensive care medicine experimental · 2023Review
- Extracorporeal Carbon Dioxide Removal: From Pathophysiology to Clinical Applications; Focus on Combined Continuous Renal Replacement Therapy.Biomedicines · 2023Review
- Increased Longevity of a Novel Gas Exchanger System for Low-Flow Veno-Venous Extracorporeal CO2 Removal in Acute Hypercapnic Respiratory Failure.Blood purification · 2023Article
- Extracorporeal COBMJ open respiratory research · 2021Article
- Article
- Extracorporeal carbon dioxide removal (ECCO2R) in COPD and ARDS patients with severe hypercapnic respiratory failure. A retrospective case-control studyTurkish journal of medical sciences · 2021Article
- The use of extracorporeal COAnnals of intensive care · 2021Review
- How to ventilate obstructive and asthmatic patients.Intensive care medicine · 2020Review
- Severity of endothelial dysfunction is associated with the occurrence of hemorrhagic complications in COPD patients treated by extracorporeal COIntensive care medicine · 2020Article
- Physiological effects of adding ECCOAnnals of intensive care · 2020Article
- A COJournal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2020Article
- ERS International Congress, Madrid, 2019: highlights from the Respiratory Intensive Care Assembly.ERJ open research · 2020Article
Corrections and comments
- Commented on by
Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionExtracorporeal carbon dioxide removal (ECCO2R) has been proposed for hypercapnic respiratory failure in chronic obstructive pulmonary disease (COPD) exacerbations, to avoid intubation or reduce length of invasive ventilation. Balance of risks, efficacy, and benefits of ECCO2R in patients with COPD is unclear.
methodsWe systematically searched MEDLINE and EMBASE to identify all publications reporting use of ECCO2R in COPD. We looked at physiological and clinical efficacy. A favorable outcome was defined as prevention of intubation or successful extubation. Major and minor complications were compiled.
resultsWe identified 3123 citations. Ten studies (87 patients), primarily case series, met inclusion criteria. ECCO2R prevented intubation in 65/70 (93%) patients and assisted in the successful extubation of 9/17 (53%) mechanically ventilated subjects. One case-control study matching to noninvasively ventilated controls reported lower intubation rates and hospital mortality with ECCO2R that trended toward significance. Physiological data comparing pre- to post-ECCO2R changes suggest improvements for pH (0.07-0.15 higher), PaCO2 (25 mmHg lower), and respiratory rate (7 breaths/min lower), but not PaO2/FiO2. Studies reported 11 major (eight bleeds requiring blood transfusion of 2 units, and three line-related complications, including one death related to retroperitoneal bleeding) and 30 minor complications (13 bleeds, five related to anticoagulation, and nine clotting-related device malfunctions resulting in two emergent intubations).
conclusionThe technique is still experimental and no randomized trial is available. Recognizing selection bias associated with case series, there still appears to be potential for benefit of ECCO2R in patients with COPD exacerbations. However, it is associated with frequent and potentially severe complications. Higher-quality studies are required to better elucidate this risk-benefit balance.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.