Extracorporeal gas exchange.

The high mortality associated with acute respiratory failure and further exacerbation of the lung injury by mechanical ventilation continues to pose a challenge in the management of critically ill patients. By providing total gas exchange and complete lung rest, extracorporeal membrane oxygenation (ECMO) has improved the survival rate of selected neonatal, pediatric, and adult patients. Arteriovenous carbon dioxide removal (AVCO2R) was developed as a less labor intensive, less costly, and less complex technique of extracorporeal gas exchange, allowing near total CO2 removal.