“Respiratory Dialysis for Acute Respiratory Failure” – Workshop Summary

15 November 2013 Clinical Update
Prof. Ranieri at ESICM 2013 ALung Workshop

Prof. Marco Ranieri

Clinical reports of extracorporeal carbon dioxide removal (ECCO2R) provided by the Hemolung RAS were the focus of an educational workshop hosted by ALung on October 7th at the 2013 Annual Congress of the European Society of Intensive Care Medicine (ESICM) in Paris, France.

Three leading intensive care physicians provided an excellent overview of the rationale and indications for ECCO2R in cases of exacerbated COPD and acute respiratory distress syndrome (ARDS). Several positive case studies of the Hemolung RAS were also presented.

Summaries of the presentations follow.

“Low Flow Veno-Venous Support”
Prof. V. Marco Ranieri, Chairman, Department of Anesthesia and Intensive Care Medicine
University of Turin, Italy

Prof. Ranieri presented the clinical rationale for utilizing extracorporeal CO2 removal earlier in the care of patients with acute respiratory failure. He presented a detailed overview of the studies supporting the use of ECCO2R in both COPD and ARDS. Prof. Ranieri concluded his talk with a case report of utilizing the Hemolung RAS to facilitate protective, independent lung ventilation in a very complicated pneumonia patient.

Prof. Ranieri’s slides are available for download here.

“Extracoporeal CO2 Removal in COPD”
Dr. med Markus Engel, Chief of the Medical Intensive Care Unit
Klinikum Bogenhausen, Munich, Germany

In his presentation, Dr. Engel called for a paradigm change in the treatment of acute exacerbations of COPD to include minimally invasive extracorporeal CO2 removal. Dr. Engel presented compelling data, including three Hemolung RAS cases, supporting the use of ECCO2R to avoid intubation in cases of NIV failure. In one case, Dr. Engel reported reversal of hypercapnic coma in a patient with an acute exacerbation of COPD failing non-invasive ventilation. This case has been accepted for publication at the 2013 DIVI Congress in Leipzig, Germany.

“Extracoporeal CO2 Removal in ARDS”
Dr. Nicholas Barrett, Consultant in Critical Care
Guy’s and St Thomas’ NHS Foundation Trust, London, UK

As the lead physician for Severe Respiratory Failure and ECMO at St Thomas’ Hospital in London, Dr. Nicholas Barrett treats patients with particularly difficult cases of respiratory failure. Dr. Barrett presented his rationale and practical guidance for the use of extracorporeal carbon dioxide removal to facilitate lung protective ventilation in ARDS, drawing on his experiences with both the Hemolung RAS and traditional ECMO systems.