Refractory traumatic bronchopleural fistula: Is extracorporeal membrane oxygenation the new gold standard?

Introduction: A refractory bronchopleural fistula leading to respiratory failure in a trauma patient is one of the most challenging pathologies to manage in one of the most challenging patient populations. Modern equipment and techniques have decreased and perhaps even eliminated the need for anticoagulation with ECMO, and it is finding an important niche in saving this patient population from refractory hypoxia. We review here our experience with three refractory traumatic bronchopleural fistulae utilizing venovenous ECMO as the primary treatment modality.

DCD and DBD lung transplantation optimized by ex vivo perfusion: What to do when the pump fails.

Background: Ex vivo perfusion is a safe and feasible method of assessing and using high-risk donor organs.

Aim: We describe a case of successfully ex vivo treated and transplanted human lung allografts.

Methods: Donor human lungs were assessed using ex vivo, our trouble shooting protocol allowed safe recovery.

In vivo resuscitation, perfusion, and transplantation of a porcine cardiac allograft donated after circulatory death.

Objectives: To test the feasibility of a novel method of heart donation under circulatory death criteria that allows precardiectomy donor heart assessment.

Materials And Methods: This is a translational study utilizing 16 female Yorkshire pigs in a series of eight heart transplant procedures under a circulatory death model.

Results: Successful resuscitation of the donor hearts occurred in seven out of eight animals.

Rescue therapy for hypercapnia due to high PEEP mechanical ventilation in patients with ARDS and renal failure.

Extracorporeal removal of carbon dioxide in patients experiencing severe hypercapnia due to lung protective mechanical ventilation was first described over four decades ago. There have been many devices developed and described in the interim, many of which require additional training, resources, and staff. This manuscript describes a readily available and relatively simple adjunct that can provide partial lung support in patients with acute respiratory distress syndrome complicated by severe hypercapnia and acute kidney injury requiring dialysis.