True Lung Protection Beyond Current Standards

Less is more!

The seminal ARDSnet trial demonstrated that lower tidal volumes of 6 ml/kg ideal body weight are associated with lower mortality. Later analyses showed that a further reduction of the tidal volume is a sensible approach to protect the lung. However, this must not be compensated by unnaturally high respiratory rates, since every respiratory cycle is associated with further barotrauma and volutrauma and works against the primary goal of promoting spontaneous breathing.

 

CO2 elimination via an artificial lung

The use of the iLA Membrane Ventilator® enables ventilator settings well beyond previously accepted “protective” ventilation. Clinical experience has shown that so-called “ultra-protective” tidal volumes of 3 ml/kg IBW can be realised. The result is a significant reduction in inflammatory reactions.

The iLA Membrane Ventilator® artificial lung enables the removal of carbon dioxide outside the human lung and is perfused with blood by the heart like a natural organ. The patient’s lung receives gas exchange support and is thus better protected. By avoiding the use of a mechanical blood pump additional hemolysis is avoided and inflammatory reactions are reduced.

 

High-frequency oscillatory ventilation (HFOV) – lung protection through protective oxygenation

A special form of mechanical ventilation, (HFOV) enables extremely gentle ventilation in particular in cases of hypoxaemic lung failure.

A continuous flow of inlet gas in the CPAP circuit of the Vision α® HFOV is put in motion by the movements of an oscillating membrane. The resulting tidal volume is lower than the anatomical dead space, reducing end-inspiratory overdistension of lung tissue to a minimum. At the same time, a continuous distension pressure enables a targeted implementation of the open lung concept. This prevents end-expiratory alveolar collapse and improves oxygenation through an increase in the functional residual capacity.