PMID- 18640306 OWN - NLM STAT- MEDLINE DCOM- 20080903 LR - 20201209 IS - 1552-6259 (Electronic) IS - 0003-4975 (Linking) VI - 86 IP - 2 DP - 2008 Aug TI - Pumpless extracorporeal lung assist: a 10-year institutional experience. PG - 410-7; discussion 417 LID - 10.1016/j.athoracsur.2008.04.045 [doi] AB - BACKGROUND: Pumpless extracorporeal lung assist (PECLA) was developed to support pulmonary function in patients with severe respiratory insufficiency. METHODS: Since 1996, 159 patients with an age ranging from 7 to 78 years were provided with a PECLA system. Fifteen patients were referred to us by air or ground transport after insertion of the system in a peripheral hospital. RESULTS: Main underlying lung diseases were acute respiratory distress syndrome (70.4%) and pneumonia (28.3%). Pumpless extracorporeal lung assist lasted for 0.1 to 33 days, mean 7.0 +/- 6.2 days; cumulative experience was greater than 1,300 days. Successful weaning and survival to hospital discharge was achieved in 33.1% of patients after a mean PECLA support of 8.5 +/- 6.3 days. During PECLA therapy, 48.7% of patients died, mainly as a result of multiorgan failure after a mean interval of 4.8 +/- 5.1 days. Inability to stabilize pulmonary function was noted in 3% of patients only. After PECLA, 30-day mortality was 13.6%. In a subgroup analysis, best outcome was obtained in patients after trauma. CONCLUSIONS: Pumpless extracorporeal lung assist is a simple and efficient method to support patients with deteriorating gas exchange for prolonged periods to allow the lung protective ventilation and transportation. Best indication for use of PECLA is severe hypercapnia and moderate hypoxia. FAU - Florchinger, Bernhard AU - Florchinger B AD - Department of Cardiothoracic Surgery, University Hospital, Regensburg, Germany. FAU - Philipp, Alois AU - Philipp A FAU - Klose, Alexander AU - Klose A FAU - Hilker, Michael AU - Hilker M FAU - Kobuch, Reinhard AU - Kobuch R FAU - Rupprecht, Leopold AU - Rupprecht L FAU - Keyser, Andreas AU - Keyser A FAU - Puhler, Thomas AU - Puhler T FAU - Hirt, Stephan AU - Hirt S FAU - Wiebe, Karsten AU - Wiebe K FAU - Muller, Thomas AU - Muller T FAU - Langgartner, Julia AU - Langgartner J FAU - Lehle, Karla AU - Lehle K FAU - Schmid, Christof AU - Schmid C LA - eng PT - Journal Article PL - Netherlands TA - Ann Thorac Surg JT - The Annals of thoracic surgery JID - 15030100R SB - IM MH - Adolescent MH - Adult MH - Aged MH - Cardiac Output, Low/epidemiology MH - Child MH - Female MH - Hemodynamics MH - Humans MH - Hypercapnia/therapy MH - Hypocapnia/therapy MH - Length of Stay MH - Male MH - Middle Aged MH - Multiple Organ Failure/epidemiology MH - Pulmonary Gas Exchange MH - Respiratory Distress Syndrome/*therapy MH - Respiratory Therapy/*methods EDAT- 2008/07/22 09:00 MHDA- 2008/09/04 09:00 CRDT- 2008/07/22 09:00 PHST- 2008/01/11 00:00 [received] PHST- 2008/04/07 00:00 [revised] PHST- 2008/04/07 00:00 [accepted] PHST- 2008/07/22 09:00 [pubmed] PHST- 2008/09/04 09:00 [medline] PHST- 2008/07/22 09:00 [entrez] AID - S0003-4975(08)00890-4 [pii] AID - 10.1016/j.athoracsur.2008.04.045 [doi] PST - ppublish SO - Ann Thorac Surg. 2008 Aug;86(2):410-7; discussion 417. doi: 10.1016/j.athoracsur.2008.04.045.