The Journal of Thoracic and Cardiovascular Surgery, Vol 69, 439-449, Copyright © 1975 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Extracorporeal perfusion for acute respiratory failure: recent experience with the spiral coil membrane lung
WM Zapol, J Qvist, H Pontoppidan, A Liland, T McEnany and MB Laver
Selection criteria, clinical data, and physiological measurements obtained
during five extracorporeal membrane lung perfusions for acute respiratory
insufficiency are presented. Four patients died and 1 survived. A new
technique of femoral artery cannulation to allow aortic arch perfusion is
described. When properly monitored, this route provides improved oxygen
delivery to the brain during venoarterial (VA) perfusion. The importance of
monitoring the equivalent of carotid artery Po2 during VA perfusion is
emphasized. Recognition of the effects of high cardiac output in limiting
the quality of extracorporeal perfusion, plus the use of hypothermia to
reduce output, are stressed. We have confirmed that perfusion can be
accomplished with small quantities of heparin, so that bleeding is reduced,
but thrombocytopenia and occasional hemorrhage continue to be persistent
problems.