查看文章

Since the 70s, the extracorporeal carbon dioxide removal concept played a role in adjusting respiratory acidosis associated with Tidal Volume reduction in protective ventilation settings.

Kolobow and Gattinoni in 1977 were the first in introducing extracorporeal support, with the intent to separate carbon dioxide removal from oxygen uptake: carbon dioxide was removed by a pump-driven modified ECMO with veno-venous bypass, while oxygenation was accomplished by high levels of PEEP, applying only a few ventilator breaths at low volumes and low peak inspiratory pressures (“lung rest”) to prevent damage of the compromised lungs.

Nevertheless extracorporeal support was restricted to controlled clinical trials because of the high incidence of serious complications like hemorrhage, hemolysis and neurological impairments.

Technological improvement led to the implementation of different devices less invasive for …