RT Journal Article
SR Electronic
T1 Introducing the Homburg lung: Efficacy and safety of a minimal-invasive system for extracorporeal CO<sub>2</sub> removal
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA3571
DO 10.1183/13993003.congress-2016.PA3571
VO 48
IS suppl 60
A1 Seiler, Frederik
A1 Trudzinski, Franziska
A1 Kamp, Annegret
A1 Tsitouras, Konstantinos
A1 Linn, Oliver
A1 Metz, Carlos
A1 Böhmer, Philip
A1 Kaiser, Ralf
A1 Fähndrich, Sebastian
A1 Wilkens, Heinrike
A1 Haake, Hendrik
A1 Bals, Robert
A1 Lepper, Philipp
YR 2016
UL http://erj.ersjournals.com/content/48/suppl_60/PA3571.abstract
AB Introduction: Extracorporeal CO2 removal (ECCO2R) is increasingly used as a therapeutic strategy in hypercapnic lung failure in order to avoid intubation, to allow lung protective ventilator settings, or to facilitate weaning from invasive ventilation. Here, we report on the Homburg Lung, a novel minimal-invasive mid-flow ECCO2R system which was established and successfully used at our ICU. The Homburg Lung is a pump-driven (Maquet Rotaflow) system for veno-venous ECCO2R with ¼” tubing and a 0.8 m2 surface oxygenator (Maquet Quadrox-I pediatric). Vascular access is usually established via a 19F/21cm bilumen cannula in the right internal jugular vein.Methods: To analyse efficacy and safety of the Homburg Lung, we screened our patient registry for ECCO2R procedures since 2013. Patients who underwent ECMO prior to ECCO2R were excluded. Patients who underwent ECCO2R more than one time since 2013 were only included once.Results: A total of 19 patients (age 52.3 ± 12.86 years, 42.1% female) was analysed. Ventilatory failure occurred due to COPD (47.4%), cystic fibrosis (21 %), and other origins (31.6%). The system generated a blood flow of 1.23 ± 0.29 lpm. Gas flow was 5.37 ± 2.98 lpm. Within 4 h, pCO2 could be reduced from 74.03 ± 17.51 mmHg to 55.53 ± 10.85 mmHg. Cannulation-associated complications were transient arrhythmia (1/19 patients), pneumothorax (1/19), and air embolism (1/19). Fatal complications were not registered.Conclusion: The Homburg Lung provides effective CO2 removal in hypercapnic lung failure. The cannulation is a safe procedure with complication rates comparable to those in central venous catheter implantation.