Archive for the ‘ Ventilation ’ Category

NovaLung function

Cait P. Searl

Consultant Cardiothoracic Anaesthetist / Intensivist


Broken Lungs2 (PDF)

Broken Lungs2 (PPT)

•High CO2 gradient between blood and

sweep gas allows diffusion across the membrane, allowing efficient CO2 removal

•Oxygenation limited due to arterial inflow
•Low resistance to blood flow (7mmHg at 1.5l /minute) allowing the heart to be the pump for the device
•Heparin coated biocompatible surface

The artificial lung from Novalung GmbH is the first of its kind to be naturally supplied with blood from the human heart. Since the beginning of 2003, the ILA device (Interventional Lung Assist) has been utilised to provide intermittent lung support to more than 300 patients with acute lung failure following severe inflammation or injuries, for instance. Dr. Matheis explains that it is not necessary to open up the patient’s chest and not even a general anaesthetic is needed. “The ILA device can be connected to the blood flow by two tubes without requiring an operation. It removes carbon dioxide and increases oxygen levels in the blood. This relieves the strain on the lung and gives it time to heal.”

The artificial lung, which measures only 14 x 14 cm, is capable of complementing and in some cases replacing traditional mechanical ventilation, which can seriously affect the functioning of the human body. “Mechanical ventilation is a double-edged sword,” says Dr. Matheis. “Respiratory air is normally drawn into the human lung through the creation of a partial vacuum, whereas respirators actually force air into the respiratory tract. In the case of lung failure, this unnatural pressure can damage the lung,” he explains. Affected patients require lung support for a period of approx. ten days on average, but applications lasting over a month, for example when waiting for a lung transplant, have already cropped up. By reducing mechanical ventilation, the ILA device is a safe and cost-effective alternative.

(Baden-WĂĽrttemberg – our favorite location in Europe)

N Engl J Med 2013.
DOI: 10.1056/NEJMoa1214103

prone ards


In patients with severe ARDS, early application of prolonged prone-positioning ses- sions significantly decreased 28-day and 90-day mortality. (Funded by the Programme Hospitalier de Recherche Clinique National 2006 and 2010 of the French Ministry of Health; PROSEVA number, NCT00527813.)


proning in ARDS


The Novalung® Interventional Lung Assist, often referred to as “The Novalung” or “The i-LA”, is a medical device used to remove carbon dioxide from a patient’s blood.

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More information also available from the link below:


The Novalung(R) iLA membrane ventilator: technical aspects

Ventilation Strategies and Experimental Lung Injury

John Baier M.D.

University of Manitoba

 Hypercapnea_lecture_(rev_2004) PPT version

Tissue damage in lungs following high tidal volume mechanical ventilation Tissue sections of the lungs 

In the multivariate analysis, high and traditional tidal volumes were independent risk factors for organ failure, multiple organ failure, and prolonged stay in the intensive care unit. Organ failures were associated with increased intensive care unit stay, hospital mortality, and long-term mortality.

Conclusion: Tidal volumes of more than 10 ml/kg are risk factors for organ failure and prolonged intensive care unit stay after cardiac surgery. Women and obese patients are particularly at risk of being ventilated with injurious tidal volumes.

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In our case subjects, the combination of 18 to 69 hours of diaphragmatic inactivity and mechanical ventilation was associated with marked atrophy of both slow-twitch and fast-twitch fibers of the diaphragm.

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Original Link

VGH Critical Care Grand Rounds March 16, 2012 from Ana Palomino / Julia Cheung on Vimeo.


Michael Finelli RRT, NRCP Hospital for Sick Children Toronto

• Examine traditional pressure ventilation
• Examine the introduction of volume ventilation
• Discuss a few differences between volume modes and volume targeted strategies
• Discuss the Cochrane Review data on volume targeted versus pressure-limited ventilation


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