Extracorporeal Carbon Dioxide Removal in Severe Chronic Obstructive Pulmonary Disease Exacerbation

Study Overview
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Brief Summary
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The conventional treatment for Severe acute exacerbation of Chronic obstructive pulmonary disease including noninvasive respiratory support, invasive respiratory support, etc, but there are many kinds of limitations and complications. Extracorporeal Carbon Dioxide Removal is a life support technology, which can effectively remove CO2. Recently some clinical studies have showed that ECCO2R can effectively improve the AECOPD patient's respiratory failure, avoid intubation and removal of endotracheal intubation. We performed a study to evaluate the clinical effectiveness of ECCO2R in the treatment of AECOPD patients.

Detailed Description
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With the development of technology, ECCO2R is not difficult to implement in intensive care unit. Many recently clinical studies have showed that ECCO2R can effectively remove CO2, reduce patient breathing work, improve the patient respiratory failure, and avoid endotracheal intubation. But there are also treated failure and high incidence of complications such as bleeding in the AECOPD patients with ECCO2R treatment, and the treatment related to airway management are less mentioned. Therefore, we set a more strict inclusion criteria in AECOPD patients and evaluate the clinical effectiveness and associated risk of ECCO2R in the treatment of AECOPD.

Official Title
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Evaluation of Clinical Effectiveness of ECCO2R for the Treatment of Patients With Severe Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Conditions
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COPD Exacerbation

Intervention / Treatment
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* Device: Extracorporeal Carbon Dioxide Removal


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: NPPV treatment failure: deterioration or no improvement after treatment with NPPV, pH < 7.25, PaCO2 > 70mmHg Obvious respiratory distress, RR > 30 times/min Breathing extreme fatigue Exclusion Criteria: Older than 75 years endotracheal intubation or tracheostomy obviously a lot of pus yellow phlegm, expectorate difficult Chest CT: obviously a wide range of consolidation BMI < 20 kg/m2, Dysfunction of other organ of extrapulmonary serious hemodynamic instability severe hypoxemia, PaO2 / FiO2 < 100mmHg home noninvasive positive pressure ventilation for a long time lung fungal infection contraindication of anticoagulation Platelet < 80000 per cubic millimeter Serum creatinine > 200 umol/L cardiac arrest Hospice care Refused to take part in the study

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Device: Extracorporeal Carbon Dioxide Removal|Place a double lumen catheter in jugular vein, drainage the venous blood in vitro tube, after blood-gas exchange and remove CO2, then return back to the Superior vena cava|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| incidence of avoid endotracheal intubation | avoid endotracheal intubation and Invasive mechanical ventilation | 30days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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COPD Exacerbation, Severe, ECCO2R, invasive mechanical ventilation