Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 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.

PubMed Disclaimer

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

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