(Vienna, 27-08-2015) A research group of intensive care specialists from the University Department of Internal Medicine I has investigated the suitability of a new device developed for the intensive care unit. It removes carbon dioxide from the blood of patients with pulmonary insufficiency. The new device is smaller and easier to operate than previous equipment. And, as the research group led by Thomas Staudinger discovered, it has considerable advantages for the patients.
In so-called ExtraCorporeal Membrane Oxygenation (ECMO), a machine partially or completely takes over the respiratory function of patients. It is used when lungs are severely damaged and can no longer sustain adequate gaseous exchange. The ECMO device continuously pumps blood through a membrane oxygenator, which replaces the gaseous exchange in the lungs: it removes carbon dioxide from the blood and enriches it with oxygen. Blood that has been processed in this way is then returned into the body.
Technically, an ECMO device is similar to a heart-lung machine. In order to perform ECMO, cannulae are inserted into two large blood vessels. Because of the high staffing requirements, costs and risks of complications (e.g. bleeding) associated with it, ECMO is regarded as a treatment of last resort (Ultima Ratio).
Several advantages
Because of the smaller blood volume in the machine and the specially developed pump, the new device (iLA Activv made by Novalung) has several advantages. As the study found, it is ideally suited for treating patients with lung damage that causes carbon dioxide to build up in the blood. It allows artificial ventilation to be reduced to give the lung time to heal. Since it operates with a comparatively small double cannula, it only requires one IV access.
"We were surprised how easy it was to treat our patients with it," says lead author Alexander Hermann. "Half of our test group remained conscious and some of them even stood up." The researchers' investigations found the device to be suitable for use in an intensive care unit. "Despite the small blood volume in the machine, carbon dioxide elimination works as expected. And the device seems to work more gently and carries fewer risks than previous equipment. On top of that, it has an oxygenation effect that we had not expected. You could call it a "miniaturized" ECMO," said Alexander Hermann. The study was published in the renowned journal "Intensive Care Medicine".
Intensive care medicine and research
In addition to its clinical activities, intensive care unit 13i2 in Vienna General Hospital (Director: Thomas Staudinger) attaches great importance to research and teaching. The specialisms of the intensive care unit, both in terms of patient care and research, are haemato-oncological diseases and severe respiratory failure, with particular emphasis on practice-relevant research, that is to say the clinical implementation of theoretical concepts. University research is very important but it is always the patients, and their individual physical and psychological needs, who come first. "We examined this device to see whether it is of any extra benefit to patients. Another important aspect is whether such a device can be incorporated within an intensive care department without additional costs or staffing requirements," explains lead investigator Thomas Staudinger of the University Department of Internal Medicine I of MedUni Vienna/Vienna General Hospital.
Service: Intensive Care Medicine 2015
A Novel Pump-driven Veno-venous Gas Exchange System during Extracorporeal CO2-Removal. - Alexander Hermann, Katharina Riss, Peter Schellongowski, Andja Bojic, Philipp Wohlfarth, Oliver Robak, Wolfgang R. Sperr, and Thomas Staudinger.
ASAIO Journal 2014
First Experience with a New Miniaturized Pump-Driven Venovenous Extracorporeal CO2 Removal System (iLA Activve): A Retrospective Data Analysis –,Alexander Hermann, Thomas Staudinger, Andja Bojic, Katharina Riss, Philipp Wohlfarth, Oliver Robak , Wolfgang R. Sperr, and Peter Schellongowski
» Website Intensive Care Unit 13.i2, University Department of Medicine I