A two-stage system for oxygenating and removing carbon dioxide from a physiological fluid, including: a primary exchange module configured to receive a gas having oxygen therein and a carrier fluid having carbon dioxide therein. The primary exchange module is configured to transfer oxygen from the gas to the carrier fluid and transfer carbon dioxide from the carrier fluid to the gas to create an oxygen loaded carrier fluid and a carbon dioxide load gas. A secondary exchange module is configured to receive the oxygen loaded carrier fluid and a physiological fluid having the carbon dioxide therein. The secondary exchange module is configured to transfer the oxygen from the oxygen loaded carrier fluid to the physiological fluid and transfer carbon dioxide from the physiological fluid to the carrier fluid to create an oxygen loaded physiological fluid.