title: Bridge to lung transplantation with the extracorporeal membrane ventilator Novalung in the veno-venous mode: the initial Hannover experience.
abstract: 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.
authors.affiliation: Hannover Thoracic Transplant Program, Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Fischer
authors.forename: Marius M
authors.initials: MM
authors.lastname: Hoeper
authors.forename: Sandra
authors.initials: S
authors.lastname: Tomaszek
authors.forename: Andre
authors.initials: A
authors.lastname: Simon
authors.forename: Jens
authors.initials: J
authors.lastname: Gottlieb
authors.forename: Tobias
authors.initials: T
authors.lastname: Welte
authors.forename: Axel
authors.initials: A
authors.lastname: Haverich
authors.forename: Martin
authors.initials: M
authors.lastname: Strueber
mesh_terms: 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