Extracorporeal Support of Gas Exchange

In 1979 we started the clinical application of extracorporeal CO2 removal (ECCO2R) coupled with low frequency positive pressure Ventilation, with peak–limited pressure (35 to 45 cm H2O). To date, 75 patients have been treated in our center, and in the last few years other centers applied this technique. Table 1 summarizes the total population of ARDS patients treated in Europe to date. The Overall mortality rate is approximately 50%, in a patient population whose expected mortality rate was originally greater than 90% [1]. A recent European study on ARDS (A. Artigas personal communication), using larger-entry criteria, revcaled a mortality rate in ARDS greater than 70%. In this paper we will shortly review the rationale, the indications, and the recent advances of this technique.