title: Extracorporeal lung assist with heparin-coated systems.
abstract: Extracorporeal lung assist (ELA) has been recommended for the treatment of ARDS if conventional therapy fails. However, the need for nearly complete anticoagulation is a major risk factor for hemorrhagic complications. We describe our experience with 13 ARDS patients treated with ELA using heparin-coated systems (Carmeda). Maintaining partial thromboplastin time and activated clotting time within or close to the normal range, even major surgery (20 thoracotomies and 2 laparotomies) could be performed without undue bleeding complications related to anticoagulation during extracorporeal support. Eight of the 13 patients survived. The use of heparin-coated systems allows prolonged ELA with nearly physiological coagulation function, permitting major surgical intervention. It enhances the safety margin of extracorporeal gas exchange and may ultimately extend its indications.
authors.affiliation: Department of Anesthesiology, Free University of Berlin, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Rossaint
authors.forename: K
authors.initials: K
authors.lastname: Slama
authors.forename: K
authors.initials: K
authors.lastname: Lewandowski
authors.forename: R
authors.initials: R
authors.lastname: Streich
authors.forename: P
authors.initials: P
authors.lastname: Henin
authors.forename: T
authors.initials: T
authors.lastname: Hopfe
authors.forename: H
authors.initials: H
authors.lastname: Barth
authors.forename: M
authors.initials: M
authors.lastname: Nienhaus
authors.forename: H
authors.initials: H
authors.lastname: Weidemann
authors.forename: P
authors.initials: P
authors.lastname: Lemmens
mesh_terms: D000328:Adult; D001672:Biocompatible Materials; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation*; D005260:Female; D006493:Heparin; D006801:Humans; D008297:Male; D010107:Oxygenators, Membrane; D011175:Positive-Pressure Respiration; D011659:Pulmonary Gas Exchange / Q000502:physiology; D012128:Respiratory Distress Syndrome / Q000401:mortality / Q000628:therapy*
chemical_list: D001672:Biocompatible Materials; D006493:Heparin