Pumpless extracorporeal interventional lung assist in patients with acute respiratory distress syndrome: a prospective pilot study

Abstract

Introduction Pumpless interventional lung assist (iLA) is used in patients with acute respiratory distress syndrome (ARDS) aimed at improving extracorporeal gas exchange with a membrane integrated in a passive arteriovenous shunt. In previous studies, feasibility and safety of the iLA system was demonstrated, but no survival benefit was observed. In the present pilot study we tested the hypothesis that timely initiation of iLA using clear algorithms and an improved cannulation technique will positively influence complication rates and management of lung protective ventilation.

Extracorporeal lung support for patients who had severe respiratory failure secondary to influenza A (H1N1) 2009 infection in Canada

“…The indications for iLA have therefore been extended by some to include the prevention of ventilator-associated lung injury during the early phase of ARDS. 13 This concept recognizes the inability to limit plateau pressures and tidal volumes in a situation of grossly diminished respiratory compliance without causing severe hypercapnia and profound respiratory acidosis. However, there are no published clinical trials regarding this device.…”

“…Recently, a pumpless circuit was developed (interventional lung assist, iLA) that is specifically effective for carbon dioxide removal. 13 So far, ECLS has been provided in specialized centres as an alternative therapy for patients who have not responded to conventional treatment. This report describes the epidemiologic characteristics, clinical features, treatment, and outcomes of a multicentre cohort of adult and pediatric Canadian ICU patients who had severe respiratory failure due to H1N1-2009 virus and were treated with ECLS.…”

Extrakorporale Lungenersatzverfahren – was gibt es Neues, was kommt?

“…Die klassischen High-flow-Gasaustauschverfahren -venovenöse und venoarterielle ECMO -sind mittlerweile [34]. [17].…”

Extracorporeal Carbon Dioxide Removal (ECCO2R) in Respiratory Failure: An Overview, and where Next?

“…Furthermore, ECCO 2 R could be used to reduce the tidal volume to less than 6 mL/kg when the plateau pressure is already less than 30 cmH 2 O ('ultraprotective' ventilation). Whether or not there is any benefit to ultra-protective ventilation is debatable, but the results of two recent studies 10,14 addressing this issue in patients with early (<72 hr) ARDS are worthy of further mention:…”