RESPIRATORY SYSTEM: Edited by Marco RanieriManagement of acute hypercapnic respiratory failurePisani, Lara; Corcione, Nadia; Nava, StefanoAuthor Information Department of Clinical, Integrated and Experimental Medicine (DIMES), Respiratory and Critical Care Unit, Sant’Orsola Malpighi Hospital, Alma Mater University, Bologna, Italy Correspondence to Stefano Nava, Department of Clinical, Integrated and Experimental Medicine (DIMES), Respiratory and Critical Care, Sant’Orsola Malpighi Hospital, Via Massarenti n.9, 40138 Bologna, Italy. E-mail: [email protected] Current Opinion in Critical Care: February 2016 - Volume 22 - Issue 1 - p 45-52 doi: 10.1097/MCC.0000000000000269 Buy Metrics Abstract Purpose of review The objective of this article is to review the most recent literature regarding the management of acute hypercapnic respiratory failure (AHRF). Recent findings In the field of AHRF management, noninvasive ventilation (NIV) has become the standard method of providing primary mechanical ventilator support. Recently, extracorporeal carbon dioxide removal (ECCO2R) devices have been proposed as new therapeutic option. Summary NIV is an effective strategy in specific settings and in selected population with AHRF. To date, evidence on ECCO2R is based only on case reports and case-control trials. Although the preliminary results using ECCO2R to decrease the rate of NIV failure and to wean hypercapnic patients from invasive ventilation are remarkable; further randomized studies are needed to assess the effects of this technique on both short-term and long-term clinical outcomes. Copyright © 2016 YEAR Wolters Kluwer Health, Inc. All rights reserved.