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BJA Advance Access published online on November 18, 2005
British Journal of Anaesthesia, doi:10.1093/bja/aei274
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Accepted October 8, 2005

Clinical Investigation

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

M. Zimmermann 1, T. Bein 1 *, A. Philipp 2, K. Ittner 1, M. Foltan 2, J. Drescher 1, F. Weber 3, and F.-X. Schmid 2

1 Department of Anesthesiology, University of Regensburg, Germany; German Air Rescue, Team DRF, Air Medical Rescue Center, Regensburg, Germany
2 Department of Cardiothoracic and Vascular Surgery, University of Regensburg, Germany
3 Department of Anesthesiology, University of Regensburg, Germany

* To whom correspondence should be addressed.
T. Bein, E-mail: thomas.bein{at}klinik.uni-regensburg.de


  Abstract

Background. 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.

Methods. 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.

Results. After implementation of iLA, a rapid increase in CO2-elimination (PaCO2 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 (Pao2 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.

Conclusions. 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.

Keywords: complications; acute respiratory distress syndrome; complications; hypercapnia; ventilation; pumpless interventional lung assist; transportation.
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