What every intensivist should know about extracorporeal CO₂ removal in ARDS

Journal of Critical Care 2026 Open access

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Authors: Luis Alexander Peña-López, Guillermo Ortiz-Ruiz, Manuel Garay-Fernández, Henry Mauricio Parada-Gereda, David Ballesteros-Castro, Gonzalo Ramírez-Guerrero
DOI: 10.1016/j.jcrc.2026.155475
Cited by: 3
References: 22

Abstract

• ECCO₂R enables ultraprotective ventilation by safely reducing tidal volume and driving pressure in ARDS. • Appropriate patient selection based on respiratory mechanics, hypercapnia, and ventilatory inefficiency is essential. • Integration of ECCO₂R requires protocolised monitoring across ventilatory, hemodynamic, renal, and hematologic domains. • ECCO₂R should be considered after lung-protective strategies, including prone positioning and PEEP titration, are exhausted. • ECCO₂R is not a substitute for ECMO; its role in ARDS is to enable ultraprotective ventilation.

Fields of Study & Subjects

Respiratory Support and Mechanisms Mechanical Circulatory Support Devices Abdominal Surgery and Complications

Publication details

Journal / source
Journal of Critical Care
Publisher
Elsevier BV
Volume
93
Pages
155475–155475
Publication date
16 February 2026
Language
EN