What is chronic obstructive pulmonary disease (COPD)?

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide with an estimated number of 550 million people suffering from this disease.[1] According to World Health Organization (WHO), more than three million people die on COPD every year. The number is prognosed to increase in the coming years.[2]

COPD is an umbrella term for several permanent, progressive diseases of the respiratory airways. The most important characteristics of COPD are persistent respiratory symptoms and airflow limitation. COPD patients often show hypercapnia as a result of the impaired gas exchange.[3]

A characteristic of COPD are acute exacerbations (AECOPD), phases in which COPD patients experience acute worsening of their respiratory symptoms.[3] Approximately 40% of hospitalized AECOPD patients need forms of respiratory support with an intubation rate of estimated 50%.[4-6] With prolonged invasive mechanical ventilation (IMV), mortality risk also increases.[7]

ECCO2R seems to be able to reduce or even avoid invasive mechanical ventilation. With ECCO2R gas exchange is managed extracorporeally and thereby the respiratory system is supported. Further evidence is still needed.[8,9]  

Treatments for ventilatory support have been, and are, well accepted and widely used.[4] ECCO2R as a treatment for respiratory support of AECOPD patients has great potential to achieve the same goal.[8,9]

[1] Hammond, E. E. et al. (2020). The global impact of Aspergillus infection on COPD. BMC Pulm Med, 20(1), 241-251

[2] World Health Organization. (2022). Chronic obstructive pulmonary disease (COPD). Accessed November 3, 2022 https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd)

[3] Global Initiative for Chronic Obstructive Lung Disease (2022). Global Strategy for Prevention, Diagnosis and Management of COPD: 2022 Report.

[4] Lindenauer, P. K. et al. (2014). Outcomes associated with invasive and noninvasive ventilation among patients hospitalized with exacerbations of chronic obstructive pulmonary disease. JAMA Intern Med, 174(12), 1982-1993

[5] Tsai, C-L. et al. (2013). Comparative effectiveness of noninvasive ventilation vs invasive mechanical ventilation in chronic obstructive pulmonary disease patients with acute respiratory failure. J Hosp Med, 8(4), 165-172

[6] Conti, G. et al. (2002). Noninvasive vs. conventional mechanical ventilation in patients with chronic obstructive pulmonary disease after failure of medical treatment in the ward: a randomized trial. Intensive Care Med, 28(12), 1701-1707

[7] Esteban, A. et al. (2022). Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study. 287(3), 345-355

[8] Abrams, D. et al. (2014). Extracorporeal membrane oxygenation in cardiopulmonary disease in adults. J Am Coll Cardiol, 63(25 Pt A), 2769-2778

[9] Combes, A. et al. (2020). ECCO2R therapy in the ICU: consensus of a European round table meeting. Crit Care, 24(1), 490-500