The pumpless extracorporeal lung membrane provides complete respiratory support during complex airway reconstructions without inducing cellular trauma or a coagulatory and inflammatory response

Sánchez-Lorente, David; Iglesias, M.; Rodríguez, Alberto; Jungebluth, Philipp; Macchiarini, Paolo

doi:10.1016/j.jtcvs.2012.04.002

Cited by 17 publications

(10 citation statements)

References 24 publications

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“…To avoid these problems, intermitted cross-field ventilation was introduced, but it did not solve the limits of continuous ventilation. Sanchez-Lorente et al 18 proposed apneic oxygenation that was characterized by hyperventilation with a high percentage of O 2 for several minutes before carinal resection, with the positioning of a small catheter in the left main bronchus with a high flow of oxygen that maintained a satisfactory blood-gas exchange for several minutes allowing anastomosis execution. Jet ventilation was another proposed method to maintain ventilation during carinal resection.…”

Section: Discussionmentioning

confidence: 99%

Preliminary Results of Extracorporeal Membrane Oxygenation Assisted Tracheal Sleeve Pneumonectomy for Cancer

Spaggiari

Sedda

Petrella

et al. 2020

Thorac Cardiovasc Surg

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Objective Tracheal sleeve pneumonectomy is a challenge in lung cancer management and in achieving long-term oncological results. In November 2018, we started a prospective study on the role of extracorporeal membrane oxygenation (ECMO) in tracheal sleeve pneumonectomy. We aim to present our preliminary results. Methods From November 2018 to November 2019, six patients (three men and three women; median age: 61 years) were eligible for tracheal sleeve pneumonectomy for lung cancer employing the veno-venous ECMO during tracheobronchial anastomosis. Results Only in one patient, an intrapericardial pneumonectomy without ECMO support was performed, but cannulas were maintained during surgery. The median length of surgery was 201 minutes (range: 162–292 minutes), and the average duration of the apneic phase was 38 minutes (range: 31–45 minutes). No complications correlated to the positioning of the cannulas were recorded. There was only one major postoperative complication (hemothorax). At the time of follow-up, all patients were alive; one patient alive with bone metastasis was being treated with radiotherapy. Conclusion ECMO-assisted oncological surgery was rarely described, and its advantages include hemodynamic stability with low bleeding complications and a clean operating field. As suggested by our preliminary data, ECMO-assisted could be a useful alternative strategy in select lung cancer patients.

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Section: Discussionmentioning

confidence: 99%

Preliminary Results of Extracorporeal Membrane Oxygenation Assisted Tracheal Sleeve Pneumonectomy for Cancer

Spaggiari

Sedda

Petrella

et al. 2020

Thorac Cardiovasc Surg

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“…Несмотря на то что число наблюдений пока невелико, предварительные результаты свидетельствуют о большей безопасности ЭКМО по сравнению с традиционным ИК. Преимущество методики авторы видят в меньшей гепаринизации, существенном снижении риска диссеминации опухолевых клеток, уменьшении частоты кровотечений и повреждения легкого [28].…”

Section: Discussionunclassified

Cardiopulmonary bypass in thoracic surgery

Bazarov

IuV

Charchyan

et al. 2017

Khir. Z. im. N.I. Pirogova

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“…As the CO drives the extracorporeal blood circulation during pECLA, a membrane oxygenator with a small resistance is indispensable. Significant progress has been made regarding the material characterized by minimized pressure decrease across the membrane and reduced extracorporeal surfaces allowing for near-total carbon dioxide removal and moderate oxygenation with minimal cellular trauma, coagulation alterations and immunologic response ( 25 – 29 ). Thus, the present study further investigated the respiratory effects of pECLA in the experimental model.…”

Section: Discussionmentioning

confidence: 99%

Effects of pumpless extracorporeal lung assist on hemodynamics, gas exchange and inflammatory cascade response during experimental lung injury

Wang

et al. 2017

Exp Ther Med

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Pumpless extracorporeal lung assist (pECLA) has been reported to efficiently remove the systemic CO2 production and provide mild to moderate oxygenation, thereby allowing for ventilator settings and modes prioritizing oxygenation and lung protection. However, an adequate bypass flow, the capacity to provide respiratory support and the effect on the inflammatory cascade response and tissue perfusion require further study to be determined. After induction of acute lung injury (ALI) by oleic acid injection, pECLA was implemented in 12 anaesthetized and mechanically ventilated dogs for 48 h. Improved oxygenation [partial oxygen pressure (PaO2) and oxygen saturation (SaO2) was measured by arterial blood gas analysis, and increased by 29 and 18%, respectively] and CO2 elimination (partial CO2 pressure decreased by 43.35%) were obtained after pECLA implementation. A maximum arterio-venous shunt flow of up to 25% of the foundational CO resulted in stable hemodynamics. The pECLA procedure did not elicit any further increase in the concentration of tumor necrosis factor-α, interleukin (IL)-6, IL-8 and endothelin-1 compared with that in the group subjected to oleic acid injection only. In addition, the pECLA procedure had no effect on lactate levels and urine production. In conclusion, pECLA is an efficient and promising strategy for providing a mild to moderate oxygenation and adequate decarboxylation, while avoiding excessive inflammatory cascade response and tissue hypoperfusion in an experimental ALI model.

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The pumpless extracorporeal lung membrane provides complete respiratory support during complex airway reconstructions without inducing cellular trauma or a coagulatory and inflammatory response

Abstract: Data suggest that iLA provides complete intraoperative respiratory support in patients who cannot receive conventional intubation/ventilation without relevant effects on cellular trauma, coagulatory response, and inflammatory response.

Cited by 17 publications

References 24 publications

Preliminary Results of Extracorporeal Membrane Oxygenation Assisted Tracheal Sleeve Pneumonectomy for Cancer

Preliminary Results of Extracorporeal Membrane Oxygenation Assisted Tracheal Sleeve Pneumonectomy for Cancer

Cardiopulmonary bypass in thoracic surgery

Effects of pumpless extracorporeal lung assist on hemodynamics, gas exchange and inflammatory cascade response during experimental lung injury

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