title: Pumpless extracorporeal lung assist: a 10-year institutional experience.
abstract: BACKGROUND
  Pumpless extracorporeal lung assist (PECLA) was developed to support pulmonary function in patients with severe respiratory insufficiency.
  
  
  METHODS
  Since 1996, 159 patients with an age ranging from 7 to 78 years were provided with a PECLA system. Fifteen patients were referred to us by air or ground transport after insertion of the system in a peripheral hospital.
  
  
  RESULTS
  Main underlying lung diseases were acute respiratory distress syndrome (70.4%) and pneumonia (28.3%). Pumpless extracorporeal lung assist lasted for 0.1 to 33 days, mean 7.0 +/- 6.2 days; cumulative experience was greater than 1,300 days. Successful weaning and survival to hospital discharge was achieved in 33.1% of patients after a mean PECLA support of 8.5 +/- 6.3 days. During PECLA therapy, 48.7% of patients died, mainly as a result of multiorgan failure after a mean interval of 4.8 +/- 5.1 days. Inability to stabilize pulmonary function was noted in 3% of patients only. After PECLA, 30-day mortality was 13.6%. In a subgroup analysis, best outcome was obtained in patients after trauma.
  
  
  CONCLUSIONS
  Pumpless extracorporeal lung assist is a simple and efficient method to support patients with deteriorating gas exchange for prolonged periods to allow the lung protective ventilation and transportation. Best indication for use of PECLA is severe hypercapnia and moderate hypoxia.
authors.affiliation: Department of Cardiothoracic Surgery, University Hospital, Regensburg, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Flörchinger
authors.forename: Alois
authors.initials: A
authors.lastname: Philipp
authors.forename: Alexander
authors.initials: A
authors.lastname: Klose
authors.forename: Michael
authors.initials: M
authors.lastname: Hilker
authors.forename: Reinhard
authors.initials: R
authors.lastname: Kobuch
authors.forename: Leopold
authors.initials: L
authors.lastname: Rupprecht
authors.forename: Andreas
authors.initials: A
authors.lastname: Keyser
authors.forename: Thomas
authors.initials: T
authors.lastname: Pühler
authors.forename: Stephan
authors.initials: S
authors.lastname: Hirt
authors.forename: Karsten
authors.initials: K
authors.lastname: Wiebe
authors.forename: Thomas
authors.initials: T
authors.lastname: Müller
authors.forename: Julia
authors.initials: J
authors.lastname: Langgartner
authors.forename: Karla
authors.initials: K
authors.lastname: Lehle
authors.forename: Christof
authors.initials: C
authors.lastname: Schmid
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002303:Cardiac Output, Low / Q000453:epidemiology; D002648:Child; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006935:Hypercapnia / Q000628:therapy; D016857:Hypocapnia / Q000628:therapy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000453:epidemiology; D011659:Pulmonary Gas Exchange; D012128:Respiratory Distress Syndrome / Q000628:therapy*; D012138:Respiratory Therapy / Q000379:methods*