Abstract:

To summarize the nursing experience of 3 patients with severe hypercapnia during the acute exacerbation of chronic obstructive pulmonary disease（COPD） undergoing extracorporeal carbon dioxide removal（ECCO₂R），as well as adjustment of oxygen therapy support strategy and implementation of non-pharmacological airway clearance techniques. Additionally，the nursing focus includes all process nursing of ECCO₂R，which covers the key aspects such as catheter selection and placement management，pre-flush setting and bubble handling，dual connection with initial parameter setting for patients，heparin pathway management and bleeding monitoring，observation of thrombosis formation and pressure monitoring during operation and self-examination，evaluation of carbon dioxide removal efficiency and implementation of decommissioning tests. After careful treatment and nursing，2 patients recovered and were discharged，and a patient’s condition improved and was transferred to the respiratory ward for further treatment，and was discharged after 5 days.

Key words: Extracorporeal Carbon Dioxide Removal, Pulmonary Disease, Chronic Obstructive, Hypercapnia, Critical Care

摘要：

总结3例慢性阻塞性肺疾病合并高碳酸血症患者进行体外二氧化碳清除的护理经验。护理要点包括制订并实施体外二氧化碳清除全程化护理流程（the all process nursing of extracorporeal carbon dioxide removal，ECCO₂R-APN）、调整氧疗支持策略及实施非药物气道廓清技术，其中，ECCO₂R-APN包括导管选择及置管管理、预冲设置及气泡处理、设置初始参数同时连接体外二氧化碳清除引回血管路、肝素通路管理及出血监测、观察血栓形成及监测运行和自检过程中的压力、评估二氧化碳清除效率及实施撤机试验。经过精心治疗及护理，2例康复出院，1例病情好转至呼吸科病房继续治疗，并于5 d后康复出院。

关键词: 体外二氧化碳清除, 肺疾病, 慢性阻塞性, 高碳酸血症, 危重症护理