Source: Annual Congress 2010 - Acute respiratory failure
Disease area: Respiratory critical care

Abstract

INTRODUCTION: The Hemolung compared to invasive mechanical ventilation could be clinically and economically superior to support hypercarbic respiratory failure.
Case Description : A 76 years female with COPD, OHS, OSA with renal insufficiency , hypertension and anemia with hypercarbic respiratory failure on NIMV for 17 hours . She was NIMV failure as pH and PaCO2 deteriorated from pH 7.250, PaCO2 76.2 mm Hg to pH 7.155, PaCO2 102 mm Hg and encephalopathy score 1 to 3.
Method: The Hemolung (CO₂ removal device) consists of a bundle of hollow fibers assembled around a rotating core held within a clear housing. The catheter is dual lumen 15.5 Fr inserted via the femoral vein employing the veno/ venous approach.Excess O₂ and CO₂ are released via vacuum to the external console. The circuit blood flow was between 400-450ml/min and CO2 removal began at 80-90ml/min and then decreased over time as PaCO2 decreased.
Discussion: The hemolung respiratory assist system was successfully employed to correct hypercarbic acidosis in a case of NIMV failure. This is a first human study as a part of a multicentric pilot study.

Time	0 hours Hemo lung initiated	1 hr	12 hr	24 hr	48 hr	78 hr Hemo Lung discontinued	92 hr
pH	7.161	7.244	7.287	7.217	7.367	7.320	7.391
PaCO2	103	78.8	66.6	82	56.5	67.4	72.1
PaO2	60.9	58.6	50.2	110	59.1	58.6	61.1
HCO3	35.3	32.9	30.8	32.1	31.7	33.8	42.8
RR	24	21	21	23	16	24	24
SPO2	95	90	94	90	86	94	94
Encephalopathy Score	3	2	0	1	0	0	0

Trends of ABG and other parameters on Hemolung

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R. K. Mani, N. Burki, D. Govil, S. Upadhyaya, R. Basu, K. N. Gupta, S. Bhatnagar, N. Gupta, J. Goyal, T. Rawat (Gurgaon, India; Farmington, United States Of America). Hemo Lung: A new extracorporeal system for respiratory support. Eur Respir J 2010; 36: Suppl. 54, 2300

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