Authors: L. Keith Scott, MD, MSc, FCCM
Summary: This report describes the case of a 57-year-old male with COVID-19 who was transferred to our facility for consideration of treatment with ECMO. The patient was maintaining acceptable levels of oxygenation but was severely hypercapnic with a PaCO2 of 188 mmHg refractory to ventilation adjustments. Instead of ECMO, the patient was treated with extracorporeal CO2 removal (ECCO2R) via percutaneous insertion of a 15.5 French central venous catheter and low blood flows of only 500 mL/min. The patient was anticoagulated with argatroban during therapy to achieve standard anticoagulation levels for extracorporeal life support. The Hemolung device provided rapid and safe reduction in PaCO2 and normalization of pH within a short time and with a comparatively small catheter and performed without complications.
Source: Louisiana State University Academic Medical Center Clinical Case Report (05/13/20)