Interhospital transportation of patients with severe lung failure on pumpless extracorporeal lung assist.

Abstract

To describe the use of pumpless extracorporeal interventional lung assist (iLA) for transportation of patients with severe life-threatening acute lung failure from tertiary hospitals to a specialized centre. Retrospective analysis in eight patients with severe lung failure requiring interhospital transport, in whom implementation of an iLA system at a tertiary hospital for air/ground transportation was performed. After implementation of iLA, a rapid increase in CO2-elimination (Pa(CO2) before iLA: 8.92+/-2.9 kPa, immediately after implementation: 5.06+/-0.93 kPa, 24 h after implementation: 4.53+/-1.20 kPa [mean+/-SD], P<0.05) was observed and a significant improvement in oxygenation (Pa(O2) before iLA: 6.66+/-2.26 kPa, immediately after implementation: 10.39+/-3.33 kPa, 24 h after implementation: 10.25+/-5.46 kPa, P<0.05) was noted. During transport, no severe complications occurred. Four patients died during further treatment due to multiple trauma or multiple organ failure. Due to ease of handling, high effectiveness and relatively low costs, iLA seems to be a useful system for treatment and transportation of patients with severe acute lung injury or ARDS suffering from life-threatening hypoxia and/or hypercapnia.