Bridge to lung transplantation with the extracorporeal membrane ventilator Novalung in the veno-venous mode: the initial Hannover experience.
Conventional extracorporeal membrane oxygenation and mechanical ventilation have both been identified as significant risk factors for post-lung transplant mortality when applied as a bridge to lung transplantation. We have previously described the successful use of the extracorporeal membrane ventilator Novalung as a bridge to lung transplantation in patients with severe hypercapnia and respiratory acidosis. In this setting the Novalung was connected in the arterio-venous mode without support of a mechanical blood pump. However, in patients with predominant hypoxemia, this pumpless mode does not achieve sufficient blood oxygenation due to limited blood flow. Thus, such patients require pump-driven support. Here we describe our initial experience with the Novalung extracorporeal membrane ventilator, which was originally designed for pumpless carbon dioxide removal, as a bridge to lung transplantation in patients with ventilator-refractory hypoxemia in the veno-venous pump-driven mode.
Fischer
Stefan
S
Hannover Thoracic Transplant Program, Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany.
Hoeper
Marius M
MM
Tomaszek
Sandra
S
Simon
Andre
A
Gottlieb
Jens
J
Welte
Tobias
T
Haverich
Axel
A
Strueber
Martin
M
D000328:Adult; D003550:Cystic Fibrosis / Q000150:complications; D004867:Equipment Design; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000860:Hypoxia / Q000097:blood / Q000503:physiopathology; D016040:Lung Transplantation; D013902:Radiography, Thoracic; D013997:Time Factors; D016896:Treatment Outcome; D012122:Ventilators, Mechanical