Feasibility and safety of extracorporeal CO2 removal (ECCO2R) in order to enhance protective ventilation in Acute Respiratory Distress Syndrome
The SUPERNOVA Pilot Trial to assess the feasibility and safety of extracorporeal CO2 removal (ECCO2R) in order to enhance protective ventilation in Acute Respiratory Distress Syndrome has concluded, with plans now in place for a key Randomised Clinical Trial.
Alain Combes, Co-PI of the SUPERNOVA Trial, told ESICM that efficacy and security were the two main goals.
The available data was restricted to small numbers and single centres and close to 100 patients across sites in Europe and Canada were included.
The study did not just test the feasibility of ECCO2R, it also tested the feasibility of a superprotective ventilatory strategy supported by the use of ECCO2R.
All of the available ECCO2R strategies available at the start of the study were included and 90% of the patients reached the target of a superprotective ventilation strategy without running into the problems of respiratory acidosis.
A number of side effects was observed in a small number of patients, mostly related to the technology.
The study concluded that the use of ECCO2R to facilitate ultra-protective ventilation was feasible and reasonably safe to set up.
This trial has demonstrated that the devices exist that make it possible to control CO2 removal in patients with moderate to severe ARDS. Data from the first feasibility study will now be used to estimate an enrichment strategy that may be required to enable a patient-centred outcome RCT with some 800-1,000 patients. More data will be needed to measure the true efficacy.
Read the full article on the findings of this SUPERNOVA feasibility study here.
More ARF-related articles here.