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    Interventional procedure overview of extracorporeal carbon dioxide removal for acute respiratory failure

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    What the procedure involves

    The 2 main types of ECCO2R are vvECCO2R and avECCO2R. In both types, cannulae are connected to a low ‑resistance synthetic membrane device where exchange of CO2 occurs. In vvECCO2R, either a single ‑access double-lumen catheter or a dual ‑access system using 2 venous catheters is inserted into a large vein or veins (usually the femoral or internal jugular veins) and connected to a venovenous circuit. Flow across the membrane is maintained using a pump. In avECCO2R, cannulae are inserted into an artery and a vein (usually the femoral artery and femoral vein). Arterial blood pressure drives blood continuously through the device and it is returned through the vein.

    ECCO2R can be done using either a true ECCO2R system or a modified ECMO system. People having ECCO2R are given blood thinning drugs such as heparin to prevent blood clots forming in the circuit.

    People may have ECCO2R support for several weeks, depending on clinical need.