Pumpless extracorporeal lung assist (pECLA) in patients with acute respiratory distress syndrome and severe brain injury.
BACKGROUND
A retrospective analysis was performed to estimate the practicability of a pumpless extracorporeal lung assist system (pECLA) in trauma patients suffering from severe brain injury and the acute respiratory distress syndrome (ARDS).


METHODS
Five patients with acute severe brain injury and ARDS, ventilated in a lung protective mode, were connected to pECLA to avoid the detrimental effects of hypercapnia on intracranial pressure (ICP) and cerebral outcome. With pECLA hypercapnia was eliminated in all patients while the minute volume of artificial ventilation could be reduced. Subsequently, ICP was reduced, systemic hemodynamics and cerebral perfusion pressure remained stable. One patient died due to multi-organ failure as a consequence of multi-trauma. The remaining patients survived showing a good neurologic function.


CONCLUSIONS
pECLA is a promising alternative compared with conventional pump-driven systems for patients with ARDS and brain injury, since the pECLA system has minor restrictions, limitations and side effects.
Department of Anesthesia, University of Regensburg Hospital, 93042 Regensburg, Germany. thomas.bein@klinik.uni-regensburg.de
Thomas
T
Bein
Markus N
MN
Scherer
Alois
A
Philipp
Frank
F
Weber
Chris
C
Woertgen
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000601:surgery*; D005112:Extracorporeal Circulation / Q000295:instrumentation / Q000379:methods*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007427:Intracranial Pressure; D008297:Male; D012128:Respiratory Distress Syndrome / Q000628:therapy*