INTERVENTIONAL PULMONARY ASSISTANCE (iLA) AS A BRIDGE TO LUNG TRANSPLANTATION

According to the “International Society for Heart and Lung Transplantation” (ISHLT), between 1 and 4% of patients awaiting a lung transplant will need some type of respiratory assistance as a bridge to transplantation. The objective of this study is to analyze the results of patients assisted with the iLA “Interventional Lung Assist” system (Novalung®). MATERIAL AND METHODS The iLA respiratory assistance system (Novalung®) has been used in 12 patients as a bridge to lung transplantation (three chronic obstructive pulmonary disease, five obliterative bronchiolitis, two pulmonary fibrosis, one chest trauma, one pulmonary leiomyomatosis). The gasometric parameters that indicated the assistance were: PaO2: 76.1 ± 29; PaCO2: 110.6 ± 49; pH: 7.12 ± 0.1. The patients were anticoagulated with intravenous sodium heparin (aPTT 160-180 seconds). RESULTS Six hours after the start of respiratory assistance, the gasometric parameters were: PaO2: 89 ± 17 (p > 0.05); PaCO2: 54.6 ± 5 (p < 0.05); pH 7.34 ± 0.1 (p < 0.05). The mean time of attendance was 16.8 ± 8 (4-28) days. Of the total number of patients attended: one died during the care and the remaining 11 were transplanted, of which 8 survived the lung transplant. CONCLUSIONS Respiratory assistance using iLA (Novalung®) has proven to be an effective method as a bridge to lung transplantation. It allows to improve lung function and avoid mechanical ventilation. It is indicated in patients with nonpermissive hypercapnia to avoid mechanical ventilation. In mechanically ventilated patients, iLA assistance improves ventilator tidal volume, FiO2 and PEEP.