Emergency interventional lung assist for pulmonary hypertension

Area of Science:

• Cardiovascular and Respiratory Medicine
• Pediatric Critical Care

Background:

• Pulmonary veno-occlusive disease (PVOD) is a rare and severe condition leading to pulmonary hypertension.
• Lung transplantation is often the only definitive treatment for advanced PVOD.
• Interventional lung assist devices can provide temporary circulatory and respiratory support.

Observation:

• A 15-year-old female patient with PVOD required bridge support to lung transplantation.
• The patient had high pulmonary artery pressure, necessitating careful consideration of cannulation strategy.
• Central cannulation was employed to facilitate larger cannulae and optimize blood flow.

Findings:

• The Novalung interventional lung assist device was successfully inserted in the smallest and first pediatric patient to date.
• The device provided effective circulatory support and oxygenation, functioning as a bridge to lung transplantation.
• Extracorporeal membrane oxygenation (ECMO) was not required, simplifying management.

Implications:

• This case demonstrates the feasibility and efficacy of Novalung as a bridge therapy in pediatric patients with severe pulmonary hypertension and PVOD.
• Central cannulation is a viable strategy for optimizing device performance in smaller patients with high pulmonary pressures.
• The use of Novalung may expand treatment options for pediatric patients awaiting lung transplantation.