Differences between extracorporeal carbon dioxide removal (ECCO2R) and extracorporeal membrane oxygenation (ECMO)
ECCO2R | ECMO | ||||
---|---|---|---|---|---|
Respiratory dialysis | Membrane lung | Venovenous | Venoarterial | ||
Venovenous | Arteriovenous | ||||
Conditions treated | Hypercapnic respiratory failure | Hypercapnic respiratory failure | Hypercapnic respiratory failure | Hypercapnic respiratory failure Hypoxemic respiratory failure | Hypercapnic respiratory failure Hypoxemic respiratory failure Cardiac failure |
Circuit | VS → ML → VS VS | → ML → VS | AS → ML → VS | VS → MO → VS | VS → MO → AS |
Flow rates | 0.25–0.5 L/min | 0.5–5 L/min | 0.5–5 L/min | 2–6 L/min | 2–6 L/min |
Pros | Uses current dialysis catheters | Single-catheter options | Pumpless | Oxygenation and CO2 removal | Oxygenation and CO2 removal Cardiac support |
Cons | CO2 removal only | CO2 removal only | CO2 removal only Mean arterial pressure > 65 mm Hg required | Increased surgical complexity |
AS = arterial system; CO2 = carbon dioxide; ML = membrane lung; MO = membrane oxygenator; VS = venous system