Protective and ultra-protective ventilation: using pumpless interventional lung assist (iLA).

Abstract:

:Acute lung failure is associated with high mortality and usually requires mechanical ventilation to ensure adequate gas exchange. However, mechanical ventilation itself can be associated with major complications and can aggravate pre-existing lung disease, thus contributing to morbidity and mortality. Extracorporeal gas exchange is increasingly used when conventional mechanical ventilation has failed. In contrast to veno-venous extracorporeal membrane oxygenation (ECMO), pumpless extracorporeal interventional lung assist (iLA) is applied via an arterio-venous bypass into which a gas exchange membrane is integrated. iLA allows for efficient carbon dioxide removal, which allows for a significant reduction in ventilator settings. iLA may be a useful tool in protective or even 'ultraprotective' ventilation, enabling the application of very low tidal volumes in patients with acute respiratory failure of different etiologies. This article reviews the current status and the potential role of interventional (pumpless) lung-assist iLA within the context of lung-protective ventilation strategies.

journal_name

Minerva Anestesiol

journal_title

Minerva anestesiologica

authors

Moerer O,Quintel M

subject

Has Abstract

pub_date

2011-05-01 00:00:00

pages

537-44

issue

5

eissn

0375-9393

issn

1827-1596

pii

R02116292

journal_volume

77

pub_type

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