Thoracic surgical procedures supported by a pumpless interventional lung assist

Area of Science:

• Cardiothoracic Surgery
• Respiratory Support
• Extracorporeal Life Support

Background:

• Complex thoracic surgeries pose risks to respiratory function, especially in compromised patients.
• A pumpless interventional lung assist (iLA) was explored for novel pulmonary support during these procedures.

Purpose of the Study:

• To evaluate the feasibility and effectiveness of pumpless iLA for respiratory support in thoracic surgery.
• To assess iLA's role in enabling prolonged ventilation discontinuation and managing respiratory failure.

Main Methods:

• Ten patients undergoing thoracic surgery received respiratory support via percutaneously inserted pumpless iLA.
• Indications included tracheal surgery, lung resections, and emergency procedures for acute respiratory failure.
• Hemodynamic parameters, cardiac output, and gas exchange were monitored throughout the procedure.

Main Results:

• All surgeries were successfully completed with iLA support, with mean blood flow of 1.58 L/min.
• Moderate oxygenation improvement (49 mL/min O2 transfer) and efficient CO2 elimination (121 mL/min CO2 transfer) were observed.
• The device facilitated apneic oxygenation and was used postoperatively in 4 patients for protective ventilation.

Conclusions:

• Pumpless iLA is hemodynamically well-tolerated in respiratory compromised patients during thoracic surgery.
• It provides safe and effective respiratory support, obviating the need for cardiopulmonary bypass.
• This technology offers a viable alternative for managing respiratory function in critical surgical scenarios.