Pumpless extracorporeal lung assist as supportive therapy in a patient with diffuse alveolar hemorrhage
Renner, A.; Neukam, K.; Rösner, T.; Elert, O.; Lange, V.
International Journal of Artificial Organs 31(3): 279-281
2008
ISSN/ISBN: 0391-3988 PMID: 18373323 Document Number: 621458
Our 18- year old female patient suffered from microscopic polyangiitis. After invasive diagnostics, a diffuse alveolar hemorrhage occurred, leading to acute lung failure. In spite of differential ventilation, respiratory insufficiency and lactate- acidosis increased quickly. Due to the massive hemorrhage, a pumpless extracorporeal lung assist was implanted and, after six hours, low- dose heparinization was started. In response to this therapy, hypercapnia and acidosis improved quickly and were completely eliminated within 24 hours. Simultaneously, treatment with prednisolon and cyclophosphamid was started. After 7 days, the patient's conditions allowed weaning from the pumpless extracorporeal lung assist and after 9 days she was extubated.In conclusion, the pumpless lung assist was shown to be a very practical option to treat the most serious forms of hypercapnia, especially for patients disposed to diffuse bleeding. ( Int J Artif Organs 2008; 31: 279- 81).