Extracorporeal carbon dioxide removal (ECCO sub(2)R) in respiratory deficiency and current investigations on its improvement: a review

• Published in: Journal of artificial organs 2017-03, Vol.20 (1), p.8-17
• Main Authors: Manap, Hany Hazfiza, Abdul Wahab, Ahmad Khairi
• Format: Article
• Language: English
• ISSN: 1434-7229; 1619-0904
• DOI: 10.1007/s10047-016-0905-x

The implementation of extracorporeal carbon dioxide removal (ECCO sub(2)R) as one of the extracorporeal life support system is getting more attention today. Thus, the objectives of this paper are to study the clinical practice of commercial ECCO sub(2)R system, current trend of its development and also the perspective on future improvement that can be done to the existing ECCO sub(2)R system. The strength of this article lies in its review scope, which focuses on the commercial ECCO sub(2)R therapy in the market based on membrane lung and current investigation to improve the efficiency of the ECCO sub(2)R system, in terms of surface modification by carbonic anhydrase (CA) immobilization technique and respiratory electrodialysis (R-ED). Our methodology approach involves the identification of relevant published literature from PubMed and Web of Sciences search engine using the terms Extracorporeal Carbon Dioxide Removal (ECCO sub(2)R), Extracorporeal life support, by combining terms between ECCO sub(2)R and CA and also ECCO sub(2)R with R-ED. This identification only limits articles in English language. Overall, several commercial ECCO sub(2)R systems are known and proven safe to be used in patients in terms of efficiency, safety and risk of complication. In addition, CA-modified hollow fiber for membrane lung and R-ED are proven to have good potential to be applied in conventional ECCO sub(2)R design. The detailed technique and current progress on CA immobilization and R-ED development were also reviewed in this article.