<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2448-8909</journal-id>
<journal-title><![CDATA[Medicina crítica (Colegio Mexicano de Medicina Crítica)]]></journal-title>
<abbrev-journal-title><![CDATA[Med. crít. (Col. Mex. Med. Crít.)]]></abbrev-journal-title>
<issn>2448-8909</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Medicina Crítica A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2448-89092024000300193</article-id>
<article-id pub-id-type="doi">10.35366/117783</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Terapia extracorpórea de depuración de dióxido de carbono (ECCO2R) en el manejo del estado asmático. Experiencia de dos casos y revisión de la literatura]]></article-title>
<article-title xml:lang="en"><![CDATA[Extracorporeal carbon dioxide removal therapy (ECCO2R) in the management of status asthmaticus. Experience of two cases and literature review]]></article-title>
<article-title xml:lang="pt"><![CDATA[Terapia de depuração de dióxido de carbono extracorpóreo (ECCO2R) no tratamento do estado asmático: experiência de dois casos e revisão da literatura]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez García-Rodrigo]]></surname>
<given-names><![CDATA[Juan Pedro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jiménez del Río]]></surname>
<given-names><![CDATA[Irene]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sánchez Sánchez]]></surname>
<given-names><![CDATA[Eva María]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Roa Alonso]]></surname>
<given-names><![CDATA[David]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mohedano Gómez]]></surname>
<given-names><![CDATA[Alberto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Suarez Suarez]]></surname>
<given-names><![CDATA[José]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Universitario Severo Ochoa  ]]></institution>
<addr-line><![CDATA[Madrid ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2024</year>
</pub-date>
<volume>38</volume>
<numero>3</numero>
<fpage>193</fpage>
<lpage>197</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2448-89092024000300193&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2448-89092024000300193&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2448-89092024000300193&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: La terapia extracorpórea de depuración de dióxido de carbono (ECCO2R) es una tecnología que se ha abierto paso en el campo de la insuficiencia respiratoria en el día a día de las unidades de cuidados intensivos. Gattinoni y colaboradores sugirieron la necesidad de separar el soporte extracorpóreo oxigenador del ventilatorio. De este modo se dio paso al nacimiento de la ECCO2R que se desarrolló como soporte para pacientes con síndrome de distrés respiratorio agudo severo (SDRA) con el objetivo de mantener una ventilación protectora cuando la hipercapnia permisiva no es bien tolerada o existe una contraindicación para la misma. Sin embargo, los avances hemodinámicos y tecnológicos cada vez simplifican más el empleo de la oxigenación por membrana extracorpórea (ECMO), lo que impulsó su uso sobre el ECCO2R. Se han estudiado series de casos en los que el ECCO2R se ha utilizado para el manejo de la insuficiencia respiratoria hipercápnica de manera principal en reagudizaciones de pacientes con EPOC, casos de fístulas broncopleurales o SDRA. Lamentablemente, la falta de estudios robustos que soporten la evidencia científica de la ECCO2R en el estatus asmático hace que las indicaciones formales para este dispositivo estén limitadas y se necesite mayor experiencia y evidencia científica a su favor. En este manuscrito se describe la experiencia que hemos acumulado en nuestro centro por medio de dos casos de estatus asmáticos no ventilables y ECCO2R así como una revisión de la literatura hasta la fecha.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: Extracorporeal carbon dioxide purification therapy (ECCO2R) is a technology that has made its way into the field of respiratory failure in the daily life of intensive care units. Gattinoni et al. was the first to suggested the need to separate extracorporeal oxygenation support from purely ventilatory support. This led to the birth of ECCO2R, which was developed as a support for patients with severe acute respiratory distress syndrome (ARDS) with the aim of maintaining protective ventilation when permissive hypercapnia is not well tolerated or there is a formal contraindication. However, hemodynamic and technological advances that increasingly simplify the use of ECMO, added to the severe hypoxemia that these patients usually suffer, prompted extracorporeal membrane oxygenation (ECMO) over ECCO2R. Case series have been studied in which ECCO2R has been used for the management of purely hypercapnic respiratory failure, mainly in exacerbations of patients with COPD, cases of bronchopleural fistulas or fatal asthmatic status. Unfortunately, the lack of robust studies that support the scientific evidence of the ECCO2R in these cases means that the formal indications for this device are limited and more experience and scientific evidence is needed in its favor. This manuscript describes the experience that we have accumulated in our center through two cases of inventilable asthmatic status and ECCO2R.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo: A terapia extracorpórea de depuração de dióxido de carbono (ECCO2R) é uma tecnologia que tem entrado no campo da insuficiência respiratória no dia-a-dia das Unidades de Terapia Intensiva. Gattinoni e colaboradores sugeriram a necessidade de separar o suporte de oxigênio extracorpóreo do suporte puramente ventilatório. Isso levou ao surgimento do ECCO2R, que foi desenvolvido para dar suporte a pacientes com síndrome de desconforto respiratório agudo grave (SDRA) a fim de manter a ventilação protetora quando a hipercapnia permissiva não é bem tolerada ou há uma contraindicação para isso. No entanto, os avanços hemodinâmicos e tecnológicos têm simplificado cada vez mais o uso da ECMO, o que levou ao desenvolvimento da oxigenação por membrana extracorpórea (ECMO) em vez da ECCO2R. Foram estudadas séries de casos em que a ECCO2R foi usada para o tratamento de insuficiência respiratória puramente hipercápnica, principalmente em exacerbações de pacientes com EPOC, fístulas broncopleurais ou SDRA. Infelizmente, a falta de estudos sólidos que apoiem as evidências científicas para o ECCO2R no estado asmático significa que as indicações formais para esse dispositivo são limitadas e que são necessárias mais experiências e evidências científicas a seu favor. Este manuscrito descreve a experiência que acumulamos em nosso centro por meio de dois casos de estado asmático difícil de ventilar e ECCO2R, bem como uma revisão da literatura até o momento.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[estatus asmático]]></kwd>
<kwd lng="es"><![CDATA[insuficiencia respiratoria aguda]]></kwd>
<kwd lng="es"><![CDATA[CO2]]></kwd>
<kwd lng="es"><![CDATA[ECMO]]></kwd>
<kwd lng="es"><![CDATA[ECCO2R]]></kwd>
<kwd lng="es"><![CDATA[depuración de CO2]]></kwd>
<kwd lng="en"><![CDATA[asthmatic status]]></kwd>
<kwd lng="en"><![CDATA[acute respiratory failure]]></kwd>
<kwd lng="en"><![CDATA[CO2]]></kwd>
<kwd lng="en"><![CDATA[ECMO]]></kwd>
<kwd lng="en"><![CDATA[ECCO2R]]></kwd>
<kwd lng="en"><![CDATA[CO2 clearance]]></kwd>
<kwd lng="pt"><![CDATA[estado asmático]]></kwd>
<kwd lng="pt"><![CDATA[insuficiência respiratória aguda]]></kwd>
<kwd lng="pt"><![CDATA[CO2]]></kwd>
<kwd lng="pt"><![CDATA[ECMO]]></kwd>
<kwd lng="pt"><![CDATA[ECCO2R]]></kwd>
<kwd lng="pt"><![CDATA[depuração de CO2]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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