Combined Extracorporeal Carbon Dioxide Removal (ECCO2R) With Renal Replacement Therapy and Blood Purification in a Severe Inhalation Injury Patient-Case Report.

Severe burns complicated by inhalational trauma represent a clinically challenging combination, particularly in elderly patients with multiple comorbidities. The following case report highlights the successful management of an elderly patient with second-degree burns and inhalational trauma following a residential fire. Given the severity of the clinical presentation, a combined approach incorporating extracorporeal CO2 removal (ECCO2R) to allow for early protective ventilation, continuous renal replacement therapy for precise hydroelectrolytic management, and blood purification for early immunomodulation was implemented. The case report describes a 75-year-old male patient with multiple comorbidities, including obesity and Parkinson's disease, who presented with severe burns and inhalational injury following a residential fire. The patient was admitted to the intensive care unit (ICU) with severe respiratory compromise, requiring invasive mechanical ventilation and hemodynamic support. After a multidisciplinary assessment, preemptive installation of ECCO2R combined with renal replacement therapy and blood purification filter was decided upon. Multi-organ extracorporeal support was maintained for 96 h, resulting in substantial improvement in respiratory and hemodynamic functions. After discontinuation of extracorporeal support, the patient's renal function fully recovered, obviating the need for subsequent hemodialysis. The patient was weaned off mechanical ventilation and discharged from the ICU after a 14-day stay. He is currently under outpatient follow-up, demonstrating favorable recovery. This report underscores the efficacy and safety of the combined approach of ECCO2R, renal replacement therapy, and blood purification in patients with severe inhalational injury and burns. Early intervention showed a positive impact on the patient's clinical progression, highlighting the importance of multidisciplinary evaluation and integrated management in complex cases. Although further studies are necessary to validate these findings, this case illustrates promising potential for this therapeutic strategy in similar scenarios.