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Genny Raffaeli, Karel Allegaert, Birgit Koch, Giacomo Cavallaro, Fabio Mosca, Dick Tibboel, Enno D Wildschut
OBJECTIVE: Evaluate drug disposition of sedatives and analgesics in the Xenios/Novalung extracorporeal membrane oxygenation circuits. DESIGN: In vitro experimental study. SETTING: Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands. SUBJECTS: Nine closed-loop extracorporeal membrane oxygenation circuits, made up of the iLA Activve console with four different iLA Activve kits: two X-lung kits, two iLA-Activve iLA kits, two MiniLung kits, and three MiniLung petite kits...
February 6, 2018: Pediatric Critical Care Medicine
Konrad Hoetzenecker, Laura Donahoe, Jonathan C Yeung, Sassan Azad, Eddy Fan, Niall D Ferguson, Lorenzo Del Sorbo, Marc de Perrot, Andrew Pierre, Kazuhiro Yasufuku, Lianne Singer, Thomas K Waddell, Shaf Keshavjee, Marcelo Cypel
OBJECTIVES: Extracorporeal life support (ECLS) is increasingly used to bridge deteriorating patients awaiting lung transplantation (LTx), however, few systematic descriptions of this practice exist. We therefore aimed to review our institutional experience over the past 10 years. METHODS: In this case series, we included all adults who received ECLS with the intent to bridge to LTx. Data were retrieved from patient charts and our institutional ECLS and transplant databases...
March 2018: Journal of Thoracic and Cardiovascular Surgery
Tim Martindale, Phillip McGlone, Robert Chambers, Jon Fennell
The effects of a high carbon dioxide on cerebral perfusion and intracranial pressure are well known. We report the case of a man who presented after with a severe traumatic brain injury including intracranial and extradural haemorrhage. Neuroprotective ventilation was impossible without supramaximal tidal volumes due to a combination of chest trauma and severe bronchospasm. A pump driven Novalung iLA active® system was inserted to achieve both ARDSnet ventilation and a lowering of intracranial pressure. To our knowledge, this is the first time this system has been used to this effect...
February 2017: Journal of the Intensive Care Society
Vishnu Vasanthan, Manish Garg, Michiko Maruyama, Evangelos Michelakis, Darren H Freed, Jayan Nagendran
In end-stage idiopathic pulmonary artery hypertension (iPAH), centrally cannulated Novalung (Novalung GmbH, Hechingen, Germany) pumpless extracorporeal lung assist (pECLA) decompresses the pulmonary artery for bridge to transplantation. We report placing a 45-year-old man with end-stage iPAH and right heart failure on centrally cannulated pECLA for 82 days as a bridge to heart and double-lung transplantation (HLTx). To our knowledge, this is the longest reported bridge to transplantation in Canada and the first successful bridge to HLTx...
July 2017: Canadian Journal of Cardiology
Andreas Kaesler, Peter C Schlanstein, Felix Hesselmann, Martin Büsen, Michael Klaas, Dorothee Roggenkamp, Thomas Schmitz-Rode, Ulrich Steinseifer, Jutta Arens
Flow distribution is key in artificial lungs, as it directly influences gas exchange performance as well as clot forming and blood damaging potential. The current state of computational fluid dynamics (CFD) in artificial lungs can only give insight on a macroscopic level due to model simplification applied to the fiber bundle. Based on our recent work on wound fiber bundles, we applied particle image velocimetry (PIV) to the model of an artificial lung prototype intended for neonatal use to visualize flow distribution in a stacked fiber bundle configuration to (i) evaluate the feasibility of PIV for artificial lungs, (ii) validate CFD in the fiber bundle of artificial lungs, and (iii) give a suggestion how to incorporate microscopic aspects into mainly macroscopic CFD studies...
June 2017: Artificial Organs
Maria Celeste Buompadre, Kathleen Andres, Lee-Anne Slater, Hadi Mohseni-Bod, Anne-Marie Guerguerian, Helen Branson, Suzanne Laughlin, Derek Armstrong, Mahendranath Moharir, Gabrielle deVeber, Tilman Humpl, Osami Honjo, Shaf Keshavjee, Rebecca Ichord, Vitor Pereira, Nomazulu Dlamini
The updated American Heart Association/American Stroke Association guidelines include recommendation for thrombectomy in certain adult stroke cases. The safety and efficacy of thrombectomy in children are unknown. An 8-year-old girl experienced acute stroke symptoms on two occasions while therapeutically anticoagulated on Novalung. Computed tomography scans showed proximal vessel thrombi, which were retrieved using a Trevo device without hemorrhagic complications. Postprocedural assessment found respective decreases in the National Institutes of Health Stroke Scale score from 10 to 4 and 12 to 7...
January 2017: Pediatric Neurology
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...
January 2017: 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
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