Case 1, ♂ 26 y

-Scooter accident. Femurfracture, chest trauma ARDS due to fat embolus

-12 h post-trauma: respiratory insufficiency

-< 24 h post-trauma: prone position, 36 cm H2O PEEP, 65 cm H2O plateauP, FiO2 1.0, f 24/min, I/E = 2:1).

-SaOmin.2 max 0.88, PaCO2 min 52 mmHg (pH 7.24), MV 18 L/

-SaO2 0.72.

Case 1, ♂ 26 y

-24 h post-trauma iLA

-Flow door iLA: 1.74 – 2.08 L/min.

-Ventilatory settings: 20 cm H2O PEEP, 32 cm H2O plateauP, FiO2 0.95, f 12/min, I/E = 1:1.

-MV 5,3 L/min, PaCO2 < 45 mmHg, SaO2 > 0.90.

Case 2, ♀ 51 y

-Septic artritis ARDS

-Ventilatory settings: 42 cm H2O PEEP, 26 cm H2O plateauP, I/E = 1:1, FiO2 1.0, f 26/min.

-SaO2 0.87, PaCO2 77 mmHg (pH 7.04) MV 11.4 L/min.

Case 2, ♀ 51 y

-6 h after admission iLA.

-Flow iLA: 1.2 – 1.4 L/min.

-Ventilatory settinge within 4 h: 10 cm H2O PEEP, 32 cm H2O P, FiO2 0.5, f 20/min, I/E = 1:2.

- MV 5.0 L/min. PaCO2 < 50 mmHg, SaO2 > 0.95.

CO2- elimination in patients with acute lung injury

Prof. Dr. J. Radke

Universitätsklinik für Anästhesiologie und Operative Intensivmedizin

Direktor: Prof. Dr. med. J. Radke

CO2- elimination in patients with acute lung injury

CO2-Retention - Hypercarbia

acidosis

•reduced responsiveness; catecholamine

•decreased circulation

•cerebral vasodilatation

CO2-Elimination ECMO/iLA

Universitätsklinik für Anästhesiologie und Operative Intensivmedizin

Direktor: Prof. Dr. med. J. Radke

CO2- elimination in patients with acute lung injury

Pumpless Interventional Lung Assist iLA (Novalung®)

• characterized by a membrane gas exchange

system (lung assist device [LAD]) based on heparin-coated hollow fiber technology

•connected to the patient via arterial and venous cannulae (Seldinger’s technique)

•passive femo-femoral shunt flow generated by the arterial blood pressure passes a gas exchange membrane (in the box), in which an oxygen flow (10–12 L/min), is inserted

Universitätsklinik für Anästhesiologie und Operative Intensivmedizin

Direktor: Prof. Dr. med. J. Radke