Novel Uses of Arteriovenous Extra-Corporeal Membrane Carbon Dioxide Removal (AV-ECCO2R) – Two Case Studies

Extracorporeal carbon dioxide removal (ECCO2R) device technologies have enhanced the management of acute respiratory distress syndrome (ARDS) and other lung pathologies necessitating low tidal volume protective ventilation. We report the novel use of the interventional Lung Assist Membrane Ventilator® (iLA, Novalung GmbH) in a multi-trauma patient with pulmonary contusion and pre-existing cyanotic congenital heart disease and in a patient with raised intracranial pressure in the context of acute liver failure and primary graft non-function. In both cases, heart-lung interactions were complex, but AV-ECCO2R brought about significant improvements in respiratory indices and left/right ventricular function. The device facilitated restoration of homeostasis where other therapeutic options were limited or had failed.