RESUMEN
The recently introduced pumpless extracorporeal lung assist (PECLA) is a remarkable alternative to the conventional extracorporeal membrane oxygenation in case of severe lung failure. By establishing a shunt between femoral artery and vein using the arterio-venous pressure gradient as a driving force through a low-resistance membrane oxygenator, PECLA provides highly effective gas-exchange by preserved cardiac function. Due to its closed system, reduced priming volume and low heparin demand, the unfavourable effects of extracorporeal membrane oxygenation can be effectively diminished. Hence the small technical, financial and personal input, the PECLA can be ideally used in district hospitals and during transport as well. Our short summary demonstrates the advantages and safety of the system proven over 123 cases.
Asunto(s)
Derivación Arteriovenosa Quirúrgica , Oxigenación por Membrana Extracorpórea , Insuficiencia Respiratoria/terapia , Adulto , Anciano , Oxigenación por Membrana Extracorpórea/instrumentación , Oxigenación por Membrana Extracorpórea/métodos , Femenino , Arteria Femoral/cirugía , Vena Femoral/cirugía , Humanos , Masculino , Persona de Mediana Edad , Insuficiencia Respiratoria/etiología , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
The recently introduced minimal extracorporeal circulation system is a remarkable alternative to the conventional heart-lung machine in several cardiosurgical indications. It consists of a centrifugal pump, an oxygenator, a tip-to-tip heparin coated line set and a modified cell saver application. Due to its closed blood-air interaction-free construction and reduced priming volume, the unfavourable effects of perfusion as haemodilution, inflammatory response, locoregional malperfusion, transfusion needs, can be effectively reduced. Our short summary demonstrates the advantages and safety of the system proven over 2000 cases. The potential applications are aortocoronary bypass operations with or without arrest, left heart bypass at thoracal aneurysms, "bridge to recovery" in heart failure or subsequent to reanimation, extracorporeal membrane oxygenation and many more.