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. 2010 Jul 13;3(3):177-9.
doi: 10.1007/s12245-010-0192-x.

Successful treatment of a severely injured soldier from Afghanistan with pumpless extracorporeal lung assist and neurally adjusted ventilatory support

Thomas Bein, Eric Osborn, Hans Stefan Hofmann, Markus Zimmermann, Alois Philipp, Hans J Schlitt, Bernhard M Graf

Successful treatment of a severely injured soldier from Afghanistan with pumpless extracorporeal lung assist and neurally adjusted ventilatory support

Thomas Bein et al. Int J Emerg Med. .

Abstract

Background: Life-threatening acute lung injury due to combat and/or terror attacks is associated with high mortality. The successful management includes the use of "rescue" extracorporeal lung assist and early transport by aeromedical evacuation teams.

Aims: Description of the pre-hospital support of a severely injured soldier with a pumpless extracorporeal arterio-venous lung assist in critical hypercapnia/hypoxemia.

Method: A British soldier suffered from severe gunshot injuries to the chest and abdomen in Afghanistan. After traumatic pneumonectomy, he developed critical hypercapnia/hypoxemia. He was mechanically ventilated and supported with a pumpless interventional extracorporeal lung assist (iLA, Novalung, Talheim, Germany) and transferred to Germany.

Results: A sufficient CO(2) extraction and improvement in oxygenation enabled the safe transportation and lung protective ventilation. Weaning from mechanical ventilation was promoted by the application of a new neurally adjusted ventilatory assist (NAVA). The patient recovered, and he left Germany in stable condition.

Conclusion: Novel techniques in extracorporeal lung assist and in ventilatory support may help save lives even in disaster medicine.

Keywords: Disaster medicine; Extracorporeal lung assist; Neurally adjusted ventilatory assist; Traumatic lung injury.

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Figures

Fig. 1
Fig. 1
A severely injured soldier with acute respiratory failure and the pumpless interventional lung assist (iLA)
Fig. 2
Fig. 2
Chest imaging by computer tomography demonstrating a traumatic right pneumonectomy with packing and injured lung tissue on the left
See this image and copyright information in PMC

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References

    1. Zimmermann M, Philipp A, Schmid FX, et al. From Baghdad to Germany: use of a new pumpless extracorporeal lung assist system in two severely injured US soldiers. ASAIO J. 2007;53:e4–e6. doi: 10.1097/MAT.0b013e3180574b37. - DOI - PubMed
    1. Bein T, Weber F, Philipp A, et al. A new pumpless extracorporeal lung assist in critical hypoxemia/hypercapnia. Crit Care Med. 2006;34:1372–1377. doi: 10.1097/01.CCM.0000215111.85483.BD. - DOI - PubMed
    1. Brander L, Leong-Poi H, Beck J, et al. Titration and implementation of neurally adjusted ventilatory assist in critically ill patients. Chest. 2009;135:695–703. doi: 10.1378/chest.08-1747. - DOI - PubMed
    1. Dorlac G, Fang R, Pruitt V, et al. Air transport of patients with severe lung injury: development and utilization of the Acute Lung Rescue Team. J Trauma. 2009;66:S164–S171. doi: 10.1097/TA.0b013e31819cdf72. - DOI - PubMed