A 58-year-old man with severe coronavirus disease and acute respiratory distress syndrome received mechanical ventilation and veno venous extracorporeal membrane oxygenation (ECMO). After long-term ECMO management, oxygenation improved; however, his lung compliance remained poor and persistent bacteremia was refractory to treatment. In order to reduce the cannulation sites and promote rehabilitation, his ECMO was switched to extracorporeal carbon dioxide removal (ECCO₂R) using a dialysis catheter and centrifugal pump on day 98. The decrease in minute ventilation and esophageal pressure swings suggested that ECCO₂R reduced respiratory effort and allowed for a lung protective ventilation strategy. ECCO₂R aims to eliminate blood CO₂, but there is no dedicated device in Japan. In this case, ECCO₂R using a dialysis catheter and centrifugal pump was safely performed. Although there is no clear indication for ECCO₂R, it may be effective in cases of difficult weaning after long-term ECMO.