Extracorporeal lung support for COPD reaches a crossroad

Abstract

The natural course of chronic obstructive pulmonary disease usually evolves into a form of acute respiratory failure characterised by alveolar hypoventilation and severe respiratory acidosis. As the severity and frequency of hypercapnic respiratory failure increases, the negative evolution of the syndrome progresses. Non-invasive mechanical ventilation delays fatal evolution through restoration of sufficient alveolar ventilation.1 Unfortunately, such ventilation can fail in up to 40% of the most severe cases and patients then have to undergo invasive ventilation to restore gas exchange.