Hypercapnic respiratory failure remains a frequent challenge in Intensive Care Units, particularly in patients with chronic respiratory diseases such as Chronic Obstructive Pulmonary Disease (COPD). In recent years, techniques such as extracorporeal carbon dioxide removal (ECCO₂R) have become increasingly important in managing these cases, optimising respiratory treatment and avoiding complications associated with prolonged invasive ventilation.
At HPA Alvor, this technology is available through the Prismalung® filter, integrated with the Prismax® haemofiltration machine. This system allows ECCO₂R to be used either independently or in combination with continuous renal replacement therapy, providing flexibility and adaptability to different clinical needs.
ECCO₂R is particularly effective when implemented early, preferably within the first 24 hours after respiratory deterioration. At this stage, there is still potential for reversibility and a higher likelihood of preventing progression to severe acidosis or multi-organ failure, conditions that significantly complicate clinical outcomes.
The patient in question represents a classic scenario for this technique: refractory hypercapnic respiratory failure in the context of a COPD exacerbation triggered by pneumonia. Even with invasive mechanical ventilation, carbon dioxide (CO₂) removal was insufficient, making ECCO₂R a valuable therapeutic strategy to stabilise CO₂ levels and allow targeted treatment to act more effectively.
The use of ECCO₂R at HPA Alvor demonstrates the HPA Health Group’s commitment to providing advanced technologies that improve prognosis and the quality of care for critically ill patients.
This procedure was performed by Dr Pedro Bebiano Rouxinol, Specialist in Internal Medicine and Coordinator of Intensive Care at HPA Alvor.
4, December 2025
