The Novalung interventional lung assist as bridge to lung transplantation for self-ventilating patients - initial experience

Abstract

We report the use of the Novalung pumpless device in self-ventilating patients awaiting a lung transplantation. Two patients developed carbon dioxide retention with respiratory acidosis that did not respond to maximum medical therapy. The Novalung interventional lung assist was established as a bridge to lung transplantation. The first patient was successfully transplanted after 140 days, and this is the longest support that has been reported so far. The second patient was weaned off the Novalung after a short period. The Novalung is a valuable device for self-ventilating patients with carbon dioxide retention being bridged to lung transplantation.

Coming to terms with tissue engineering and regenerative medicine in the lung

“…Furthermore, the need for pump-based devices and associated equipment to maintain flow will likely limit miniaturization. In this regard, pumpless technologies with lowresistance diffusion membranes such as the Novalung interventional lung assist device (Novalung, Heilbronn, Germany) are now being explored for use in intensive care settings for removal of CO 2 in patients experiencing trauma, infection, and acute respiratory disease syndrome or even as a bridge to lung transplantation (13,15,26,46,51). However, even though these emerging approaches hold substantial potential for bridging toward transplantation, unlike the increasingly popular ventricular-assist devices that are emerging therapies for treating heart failure, transportable lung-assist devices are still in the research phase (74 -76, 188).…”

Lung Transplantation in Cystic Fibrosis: Trends and Controversies

“…31 PLAD may be simpler than ECMO to implement, but while PLAD can be effective at carbon dioxide removal, they have less utility in improving oxygenation. 32 Both ECMO and PLAD present challenges in terms of vascular access and infection risk.…”

Extracorporeal Membrane Oxygenation for Adult Respiratory FailureDiscussion

“…17,75,77,85 Additional technological advances beyond "traditional" systems have enhanced the ability to provide extracorporeal support to patients with severe respiratory failure. 22,70,71,[86][87][88][89][90] One important technological advance is the miniaturization of ECMO technology into a small selfcontained system with an oxygenator, a pump, and all of the components necessary to provide ECMO support. 70,71, 86 An example of this miniaturized technology is the CardioHelp system (Maquet, Wayne, New Jersey), which has been used to provide ECMO for transport, as a bridge to lung transplantation, and as a bridge to recovery for respiratory failure 70,71,86 (Fig.…”

“…22,[87][88][89][90] This system uses the patient's arterial pressure as the driving pressure through the membrane. The Novalung (Novalung, Heilbronn, Germany) is a device that has been successfully used as a bridge to both recovery and lung transplantation.…”

“…The Novalung (Novalung, Heilbronn, Germany) is a device that has been successfully used as a bridge to both recovery and lung transplantation. 22, [87][88][89][90] Additional investigation is warranted using these new devices to determine their optimal application, their impact on outcomes, and potential complications.…”