title: Cardiac output: a central issue in patients with respiratory extracorporeal support.
abstract: The iLA-activve®Novalung is a new extracorporeal device specifically designed for lung support in patients with hypercapnic and/or hypoxemic respiratory failure. To date, only low-flow applications for decompensated hypercapnic chronic obstructive pulmonary disease have been reported in the literature. Here, we briefly report three cases of iLA-activve use in patients with hypercapnic-hypoxemic acute lung failure assisted with mid-flow (up to 2.4 L/min) and different single/double venous cannulation. The main findings of our small case series were: firstly, extracorporeal blood flows over 2.0 L/min across the membrane provided clinically satisfying decarboxylation and improved oxygenation; secondly, the ratio between blood flow through the membrane and the patient's cardiac output (CO) was a major determinant for the oxygen increase. The latter could, therefore, be a useful indicator for understanding performance in the complex and multifactorial evaluation of patients with extracorporeal veno-venous lung support.
authors.affiliation: 1 Department of Health Science, Section of Anesthesiology and Intensive Care, University of Florence, Florence, Italy.|2 Department of Anesthesia and Intensive Care, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla, Florence, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Romagnoli
authors.affiliation: 1 Department of Health Science, Section of Anesthesiology and Intensive Care, University of Florence, Florence, Italy.|2 Department of Anesthesia and Intensive Care, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla, Florence, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Zagli
authors.affiliation: 3 Department of Cardiology and Cardiac Surgery, Pediatric Cardiac Intensive Care Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, Rome, Italy.
authors.forename: Zaccaria
authors.initials: Z
authors.lastname: Ricci
authors.affiliation: 1 Department of Health Science, Section of Anesthesiology and Intensive Care, University of Florence, Florence, Italy.|2 Department of Anesthesia and Intensive Care, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla, Florence, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Villa
authors.affiliation: 1 Department of Health Science, Section of Anesthesiology and Intensive Care, University of Florence, Florence, Italy.|2 Department of Anesthesia and Intensive Care, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla, Florence, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Barbani
authors.affiliation: 1 Department of Health Science, Section of Anesthesiology and Intensive Care, University of Florence, Florence, Italy.|2 Department of Anesthesia and Intensive Care, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla, Florence, Italy.
authors.forename: Fulvio
authors.initials: F
authors.lastname: Pinelli
authors.affiliation: 1 Department of Health Science, Section of Anesthesiology and Intensive Care, University of Florence, Florence, Italy.|2 Department of Anesthesia and Intensive Care, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla, Florence, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: De Gaudio
authors.affiliation: 1 Department of Health Science, Section of Anesthesiology and Intensive Care, University of Florence, Florence, Italy.|2 Department of Anesthesia and Intensive Care, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla, Florence, Italy.
authors.forename: Cosimo
authors.initials: C
authors.lastname: Chelazzi
mesh_terms: D000368:Aged; D001424:Bacterial Infections / Q000097:blood / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy; D001784:Blood Gas Analysis; D002302:Cardiac Output; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation / Q000379:methods*; D006321:Heart / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D012131:Respiratory Insufficiency / Q000097:blood / Q000382:microbiology / Q000503:physiopathology* / Q000628:therapy*; D012141:Respiratory Tract Infections / Q000097:blood / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy
chemical_list: D010100:Oxygen
keywords: ECMO; Novalung; cardiac output; decap; iLA-activve®; respiratory failure