ArticleIntensive care medicine2016
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.
Article in Intensive care medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01784367 (Extracorporeal Lung Assist to Avoid Intubation in Patients Failing Noninvasive Ventilation for Acute Hypercapnic Respiratory Failure), which is not on this map. Cited by 77 papers, 2 of them syntheses that pooled it.
What it found
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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.
Extracorporeal Lung Assist to Avoid Intubation in Patients Failing Noninvasive Ventilation for Acute Hypercapnic Respiratory Failure
Who cites it
77 citing papers in PubMed, 2 syntheses or guidelines pooled it, 172 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
- Extracorporeal COCritical care (London, England) · 2026Trial
- Therapeutic Strategy of Extracorporeal Carbon Dioxide Removal in Acute Exacerbation of Chronic Obstructive Pulmonary Disease Combined With Central Airway Stricture: A Case Report.Respirology case reports · 2026Article
- Novel extracorporeal therapies in children.Pediatric nephrology (Berlin, Germany) · 2026Article
- The Evolving Role of Extracorporeal Carbon Dioxide Removal in Acute Respiratory Failure: A Narrative Review.Cureus · 2026Review
- 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
- Prediction of Long-Term Mortality in Acute Hypercapnic Respiratory Failure with Use of Low-Flow Veno-Venous Extracorporeal COBlood purification · 2026Article
- Effect of low bicarbonate substitution solution on COIntensive care medicine experimental · 2025Article
- Comment on Akil et al. Nonintubated versus Intubated Lung Volume Reduction Surgery in Patients with End-Stage Lung Emphysema and Hypercapnia.Journal of clinical medicine · 2025Article
- Management of Asthma and COPD Exacerbations in Adults in the ICU.CHEST critical care · 2025Article
- Extracorporeal Membrane Oxygenation-Assisted Thoracic Surgery: A Series of 10 Cases.Surgical case reports · 2025Article
- Recent Advances and Future Directions in Extracorporeal Carbon Dioxide Removal.Journal of clinical medicine · 2024Review
- Highlights from the Respiratory Failure and Mechanical Ventilation Conference 2024.Breathe (Sheffield, England) · 2024Article
- Is there still a place for ECCOMedizinische Klinik, Intensivmedizin und Notfallmedizin · 2024Review
- VENT-AVOID Trial: Avoiding Acute Hypercapnic Respiratory Failure!American journal of respiratory and critical care medicine · 2024Article
- Extracorporeal Carbon Dioxide Removal in Chronic Obstructive Pulmonary Disease: It Depends on the Objective!American journal of respiratory and critical care medicine · 2024Article
- Evaluation of the safety and efficacy of extracorporeal carbon dioxide removal in the critically ill using the PrismaLung+ device.European journal of medical research · 2023Article
- Respiratory Care Management of COPD Exacerbations.Respiratory care · 2023Article
- COPD Exacerbation: Why It Is Important to Avoid ICU Admission.Journal of clinical medicine · 2023Review
17 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe aim of the study was to evaluate the feasibility and safety of avoiding invasive mechanical ventilation (IMV) by using extracorporeal CO2 removal (ECCO2R) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) and acute hypercapnic respiratory failure refractory to noninvasive ventilation (NIV).
methodsCase-control study. Patients with acute hypercapnic respiratory failure refractory to NIV being treated with a pump-driven veno-venous ECCO2R system (iLA-Activve(®); Novalung, Heilbronn, Germany) were prospectively observed in five European intensive care units (ICU). Inclusion criteria were respiratory acidosis (pH ≤ 7.35, PaCO2 > 45 mmHg) with predefined criteria for endotracheal intubation (ClinicalTrials.gov NCT01784367). The historical controls were patients with acute hypercapnic respiratory failure refractory to NIV who were treated with IMV. The matching criteria were main diagnosis, age, SAPS-II score and pH.
resultsTwenty-five cases (48.0 % male, mean age 67.3 years) were matched with 25 controls. Intubation was avoided in 14 patients (56.0 %) in the ECCO2R group with a mean extracorporeal blood flow of 1.3 L/min. Seven patients were intubated because of progressive hypoxaemia and four owing to ventilatory failure despite ECCO2R and NIV. Relevant ECCO2R-associated adverse events were observed in 11 patients (44.0 %), of whom 9 (36.0 %) suffered major bleeding complications. The mean time on IMV, ICU stay and hospital stay in the case and control groups were 8.3 vs. 13.7, 28.9 vs. 24.0 and 36.9 vs. 37.0 days, respectively, and the 90-day mortality rates were 28.0 vs. 28.0 %.
conclusionsThe use of veno-venous ECCO2R to avoid invasive mechanical ventilation was successful in just over half of the cases. However, relevant ECCO2R-associated complications occurred in over one-third of cases. Despite the shorter period of IMV in the ECCO2R group there were no significant differences in length of stay or in 28- and 90-day mortality rates between the two groups. Larger, randomised studies are warranted for further assessment of the effectiveness of ECCO2R.
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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.