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Stephan Braune, Annekatrin Sieweke, Franz Brettner, Thomas Staudinger, Michael Joannidis, Serge Verbrugge, Daniel Frings, Axel Nierhaus, Karl Wegscheider, Stefan Kluge
INTRODUCTION: The aim of the study was to evaluate the feasibility and safety of avoiding invasive mechanical ventilation (IMV) by using extracorporeal CO2 removal (ECCO2R) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) and acute hypercapnic respiratory failure refractory to noninvasive ventilation (NIV). METHODS: Case-control study. Patients with acute hypercapnic respiratory failure refractory to NIV being treated with a pump-driven veno-venous ECCO2R system (iLA-Activve(®); Novalung, Heilbronn, Germany) were prospectively observed in five European intensive care units (ICU)...
September 2016: Intensive Care Medicine
Stefano Romagnoli, Giovanni Zagli, Zaccaria Ricci, Gianluca Villa, Francesco Barbani, Fulvio Pinelli, Raffaele De Gaudio, Cosimo Chelazzi
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...
July 20, 2016: Perfusion
Jeremie Reeb, Anne Olland, Stephane Renaud, Anne Lejay, Nicola Santelmo, Gilbert Massard, Pierre-Emmanuel Falcoz
In thoracic surgery, extracorporeal life support (ECLS) techniques are performed to (I) provide a short to mid term extracorporeal mechanical support; (II) realize the gas exchanges; and (III)-depending the configuration of the circuit-substitute the failed heart function. The objective of this review is to describe the rational of the different ECLS techniques used in thoracic surgery and lung transplantation (LTx) with a specific attention to the vascular access. Venovenous extracorporeal membrane oxygenation (VV ECMO) is the most common ECLS technique used in thoracic surgery and represents the best strategy to support the lung function...
April 2016: Journal of Thoracic Disease
Jonathan Mayes, Gunaratnam Niranjan, John Dark, Stephen Clark
This case describes the technique of using dual Novalungs (a pumpless extracorporeal system) to bridge a patient with idiopathic pulmonary hypertension to bilateral lung transplantation. A 41-year old lady with idiopathic pulmonary hypertension (with a possible veno-occlusive element) presented with symptoms of end-stage heart and lung failure. This was refractory to medical management with iloprost, sildenafil and bosentan. The patient was placed on the urgent waiting list for lung transplantation and central pulmonary artery to left atrial Novalung insertion was performed...
May 2016: Interactive Cardiovascular and Thoracic Surgery
Alexander Hermann, Katharina Riss, Peter Schellongowski, Andja Bojic, Philipp Wohlfarth, Oliver Robak, Wolfgang R Sperr, Thomas Staudinger
PURPOSE: Pump-driven veno-venous extracorporeal CO2-removal (ECCO2-R) increasingly takes root in hypercapnic lung failure to minimize ventilation invasiveness or to avoid intubation. A recently developed device (iLA activve(®), Novalung, Germany) allows effective decarboxylation via a 22 French double lumen cannula. To assess determinants of gas exchange, we prospectively evaluated the performance of ECCO2-R in ten patients receiving iLA activve(®) due to hypercapnic respiratory failure...
October 2015: Intensive Care Medicine
Ranjit Lall, Patrick Hamilton, Duncan Young, Claire Hulme, Peter Hall, Sanjoy Shah, Iain MacKenzie, William Tunnicliffe, Kathy Rowan, Brian Cuthbertson, Chris McCabe, Sallie Lamb
BACKGROUND: Patients with the acute respiratory distress syndrome (ARDS) require artificial ventilation but this treatment may produce secondary lung damage. High-frequency oscillatory ventilation (HFOV) may reduce this damage. OBJECTIVES: To determine the clinical benefit and cost-effectiveness of HFOV in patients with ARDS compared with standard mechanical ventilation. DESIGN: A parallel, randomised, unblinded clinical trial. SETTING: UK intensive care units...
March 2015: Health Technology Assessment: HTA
Nikhil Prakash Patil, Prashant N Mohite, Anna Reed, Aron F Popov, Andre R Simon
Patients with idiopathic pulmonary artery hypertension in refractory right ventricular failure may decompensate acutely and die while on the lung transplantation waiting list. We describe such a patient bridged to lung transplantation with a modified surgical technique for left pulmonary artery-to-left atrium bypass using Novalung, a low-resistance diffusion membrane device.
February 2015: Annals of Thoracic Surgery
Peter Schellongowski, Katharina Riss, Thomas Staudinger, Roman Ullrich, Claus G Krenn, Christian Sitzwohl, Andja Bojic, Philipp Wohlfarth, Wolfgang R Sperr, Werner Rabitsch, Clemens Aigner, Shahrokh Taghavi, Peter Jaksch, Walter Klepetko, György Lang
In patients awaiting lung transplantation (LTX), adequate gas exchange may not be sufficiently achieved by mechanical ventilation alone if acute respiratory decompensation arises. We report on 20 patients with life-threatening hypercapnia who received extracorporeal CO2 removal (ECCO2-R) by means of the interventional lung assist (ILA®, Novalung) as bridge to LTX. The most common underlying diagnoses were bronchiolitis obliterans syndrome, cystic fibrosis, and idiopathic pulmonary fibrosis, respectively. The type of ILA was pumpless arteriovenous or pump-driven venovenous (ILA activve®, Novalung) in 10 patients each...
March 2015: Transplant International: Official Journal of the European Society for Organ Transplantation
Venkat Shankarraman, Ergin Kocyildirim, Salim E Olia, Marina V Kameneva, Ryan J Dzadony, Timothy M Maul, Marc A Simon, Hunter C Champion, William R Wagner, Christian A Bermudez
Extracorporeal membrane oxygenation (ECMO) is rarely used in patients with severe pulmonary hypertension (PH) as a bridge to lung transplantation. In this study, we assess the blood biocompatibility of the integrated CentriMag-Novalung ECMO system (venoarterial) in an acute model of PH. Severe PH (≥2/3 systemic) was induced in eight sheep through progressive ligation of the main pulmonary artery. System performance, platelet activation, thromboelastography (TEG) parameters, fibrinogen, plasma-free hemoglobin, and total plasma protein were measured at initiation, 3, and 6 hr of support in the ECMO (N = 4) and sham (N = 4) groups...
July 2014: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
David M Hoganson, Avihu Z Gazit, Umar S Boston, Stuart C Sweet, R Mark Grady, Charles B Huddleston, Pirooz Eghtesady
OBJECTIVE: To evaluate paracorporeal lung assist devices to treat neonates and children with decompensated respiratory failure as a bridge to recovery or lung transplantation. METHODS: One neonate (23 days old) and 3 young children (aged 2, 9, and 23 months) presented with primary lung disease with pulmonary hypertension, including alveolar capillary dysplasia in 2 and right pulmonary hypoplasia and primary pulmonary hypertension in 1. The patients were listed for lung transplantation but decompensated and required extracorporeal membrane oxygenation (ECMO)...
January 2014: Journal of Thoracic and Cardiovascular Surgery
Paul A Corris
Lung transplantation has become an excellent treatment option for patients with cystic fibrosis (CF) and bronchiectasis with very advanced lung disease. Despite the challenges that the CF patients present, survival is more favorable than that seen in patients with chronic obstructive pulmonary disease and pulmonary fibrosis. Although those CF and bronchiectasis patients with severe respiratory disease are often infected with organisms that display in vitro resistance to the commonly used antibiotics, they usually have successful outcomes with transplantation, which are reported to be the same as in those patients with less resistant bacteria...
June 2013: Seminars in Respiratory and Critical Care Medicine
Marcus Haushofer, Yousef Abusabha, Andrea L A Amerini, Jan Spillner, Christoph Nix, Rüdiger Autschbach, Andreas Goetzenich, Nima Hatam
OBJECTIVES: Right ventricular failure is often the final phase in acute and chronic respiratory failure. We combined right ventricular unloading with extracorporeal oxygenation in a new atrio-atrial extracorporeal membrane oxygenation (ECMO). METHODS: Eleven sheep (65 kg) were cannulated by a 28-Fr inflow cannula to the right atrium and a 25-Fr outflow cannula through the lateral left atrial wall. Both were connected by a serial combination of a microaxial pump (Impella Elect(®), Abiomed Europe, Aachen, Germany) and a membrane oxygenator (Novalung(®)-iLA membrane oxygenator; Novalung GmbH, Hechingen, Germany)...
July 2013: Interactive Cardiovascular and Thoracic Surgery
C Baufreton, A Brochet, H Darrieutort, J-M Chrétien, E Parot Schinkel, M Tanguy, E Dalmayrac, J-J Lehot
OBJECTIVE: Indications for short-term circulatory and/or respiratory support (STCRS) increased during the last years. The goal of this survey was to characterize this activity in France in 2009. STUDY DESIGN: Observational retrospective pluricentral. MATERIAL AND METHODS: Each center of cardiothoracic surgery received a questionnaire validated by the Société française de perfusion about the activity, materials and organization used for STCRS...
April 2013: Annales Françaises D'anesthèsie et de Rèanimation
Duncan Young, Sarah E Lamb, Sanjoy Shah, Iain MacKenzie, William Tunnicliffe, Ranjit Lall, Kathy Rowan, Brian H Cuthbertson
BACKGROUND: Patients with the acute respiratory distress syndrome (ARDS) require mechanical ventilation to maintain arterial oxygenation, but this treatment may produce secondary lung injury. High-frequency oscillatory ventilation (HFOV) may reduce this secondary damage. METHODS: In a multicenter study, we randomly assigned adults requiring mechanical ventilation for ARDS to undergo either HFOV with a Novalung R100 ventilator (Metran) or usual ventilatory care. All the patients had a ratio of the partial pressure of arterial oxygen (PaO) to the fraction of inspired oxygen (FiO) of 200 mm Hg (26...
February 28, 2013: New England Journal of Medicine
Thomas Bein, David Zonies, Alois Philipp, Markus Zimmermann, Erik C Osborn, Patrick F Allan, Michael Nerlich, Bernhard M Graf, Raymond Fang
BACKGROUND: Advances in oxygenator membrane, vascular cannula, and centrifugal pump technologies led to the miniaturization of extracorporeal lung support (ECLS) and simplified its insertion and use. Support of combat injuries complicated by severe respiratory failure requires critical care resources not sustainable in the deployed environment. In response to this need, a unique international military-civilian partnership was forged to create a transportable ECLS capability to rescue combat casualties experiencing severe respiratory failure...
December 2012: Journal of Trauma and Acute Care Surgery
(no author information available yet)
UNLABELLED: For cases of acute respiratory distress syndrome (ARDS) and progressive chronic respiratory failure, the first choice or treatment is mechanical ventilation. For decades, this method has been used to support critically ill patients in respiratory failure. Despite its life-saving potential, however, several experimental and clinical studies have suggested that ventilator-induced lung injury can adversely affect the lungs and patient outcomes. Current opinion is that by reducing the pressure and volume of gas delivered to the lungs during mechanical ventilation, the stress applied to the lungs is eased, enabling them to rest and recover...
2010: Ontario Health Technology Assessment Series
Yu Ri Kim, Seok Jin Haam, Yoon Ghil Park, Beom Jin Lim, Yoo Mi Park, Hyo Chae Paik
Bronchiolitis obliterans (BO) is a late onset complication of allogeneic hematopoietic stem cell transplantation (HSCT), and treatment outcome is dismal if it does not respond to immunosuppressive therapy. A 21-year-old male diagnosed with acute myeloid leukemia received an allogeneic HSCT from human leukocyte antigen- identical sibling donor. Twenty one months after transplantation, he developed progressive dyspnea and was diagnosed BO. Despite standard immunosuppressive therapy, the patient rapidly progressed to respiratory failure and Novalung® interventional lung-assist membrane ventilator was applied in the intensive care unit...
September 2012: Yonsei Medical Journal
M J Frade Mera, L Vergara Díez, N Fernández Gaute, D Montes Gil
OBJECTIVE: To describe the course of a patient with the extracorporeal CO2 removal device and discover the effect of Novalung on ventilation, considering the patient's prone position and its influence on the device's blood flow. To develop a protocol of managing and specific care of a patient with Novalung. MATERIAL AND METHODS: A case report of a patient with Novalung in a tertiary hospital ICU unit is reported. Parameters considered are hemodynamic, respiratory, pharmacological, analytical, neuromonitoring, managing of the Novalung and length of decubitus prone cycles...
July 2012: Enfermería Intensiva
David Sanchez-Lorente, Manuela Iglesias, Alberto Rodríguez, Philipp Jungebluth, Paolo Macchiarini
OBJECTIVE: Our objective was to investigate the capacity of a pumpless extracorporeal lung membrane (iLA) (Novalung; Novalung GmbH, Hechingen, Germany) to provide adequate respiratory support and the impact on morbidity/mortality during complex airway reconstruction. METHODS: Only patients unable to be ventilated via conventional intubation were eligible for the study. A larynx mask or orotracheal tubes were placed above the airway defect and the iLA was attached via femoral vessels (arteriovenous), providing extracorporeal gas exchange, apneic hyperoxygenation, and total tubeless airway reconstruction...
August 2012: Journal of Thoracic and Cardiovascular Surgery
R Kopp, R Bensberg, M Wardeh, R Rossaint, R Kuhlen, D Henzler
BACKGROUND: Extracorporeal lung support is effective to prevent hypoxaemia and excessive hypercapnia with respiratory acidosis in acute respiratory distress syndrome. Miniaturized veno-venous extracorporeal membrane oxygenation (mECMO) and arterio-venous pumpless extracorporeal lung assist (pECLA) were compared for respiratory and haemodynamic response and extracorporeal gas exchange and device characteristics. METHODS: After induction of acute lung injury by repeated lung lavage, 16 anaesthetized and mechanically ventilated pigs were randomized to mECMO (Medos Hilite/Deltastream) or pECLA (iLA Novalung) for 24 h...
May 2012: British Journal of Anaesthesia
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