Avoidance of intubation during acute exacerbation of chronic obstructive pulmonary disease for a lung transplant candidate using extracorporeal carbon dioxide removal with the Hemolung

Abstract

For patients with severe chronic obstructive pulmonary disease (COPD) experiencing an acute exacerbation, the necessity for invasive mechanical ventilation (IMV) not only is associated with high mortality but also can be particularly disadvantageous to a patient also awaiting lung transplantation. In this case report, we describe our use of a novel extracorporeal carbon dioxide removal (ECCO2R) device for partial respiratory support in such a patient whowas failing support with noninvasive ventilation (NIV). The Hemolung Respiratory Assist System (ALung Technologies, Pittsburgh, Pa) provided ECCO2R at a blood flow of approximately 500 mL/min through a single 15.5F venovenous cannula inserted percutaneously through the left femoral vein. This casewas conducted as part of the first human clinical feasibility study of theHemolung device andwas the first time the device was used at our facility.