Based on core technology developed by McGowan Institute of Regenerative Medicine faculty members William Federspiel, PhD, W.K. Whiteford professor of bioengineering, chemical engineering, and critical care medicine, and the late Brack Hattler, MD, ALung Technologies, Inc., is today a leading provider of low-flow extracorporeal carbon dioxide removal (ECCO2R) technologies for treating patients with acute respiratory failure. The company announced recently the publication of new results from an investigator-sponsored clinical study of its Hemolung Respiratory Assist System (RAS) in patients with moderate acute respiratory distress syndrome (ARDS). The Hemolung RAS, a minimally invasive artificial lung device which removes carbon dioxide independently of the lungs through a process called Respiratory Dialysis®, was shown to safely and effectively facilitate an ultra-protective mechanical ventilation strategy in this group of patients.
Many patients with respiratory failure require the assistance of a ventilator as a life-sustaining measure. Unfortunately, the positive pressure exerted by the ventilator can lead to additional injury, complications, and increased mortality. Reducing ventilator pressures has been one of the most important interventions shown to improve outcomes in these critically ill patients, and further reduction of ventilator settings beyond today’s standards may be beneficial. A limiting factor of this approach is the accumulation of carbon dioxide in the blood when ventilation is reduced. The Hemolung RAS removes carbon dioxide directly from the blood, facilitating low volume, low pressure, ultra-protective mechanical ventilation while maintaining normal carbon dioxide levels.
The feasibility of providing ultra-protective ventilation using the minimally invasive approach of the Hemolung RAS was tested in this new study. Four leading European hospitals enrolled 15 patients with moderate ARDS. The trial successfully achieved its primary endpoint of reducing tidal volume by approximately 33% while maintaining normal carbon dioxide levels. Driving pressures were also significantly reduced, and complications were minimal. Results of the study were recently published in the journal Critical Care.
“In our study, extracorporeal CO2 removal with the Hemolung RAS safely facilitated significant reductions in ventilator pressures and volumes, a strategy which may help to minimize ventilator induced lung injury in patients with ARDS,” said Dr. Jordi Mancebo, Director of Intensive Care at Hospital de Sant Pau, Barcelona, Spain. “We believe that this technology is very promising, and look forward to advancing the evaluation of ECCO2R as a participant in the SUPERNOVA study.”
ALung is participating in two larger ARDS trials to determine the effect of an ultra-protective ventilation strategy on mortality. Currently enrolling patients is the European Society of Intensive Care Medicine’s SUPERNOVA study. ALung has also been chosen as the sole technology provider for the 1140-patient UK REST Trial, the world’s first pivotal study of ECCO2R sponsored by Queen’s University Belfast.
Illustration: ALung Technologies, Inc.
Paper (Feasibility and safety of low-flow extracorporeal carbon dioxide removal to facilitate ultra-protective ventilation in patients with moderate acute respiratory distress syndrome. Vito Fanelli, Marco V. Ranieri, Jordi Mancebo, Onnen Moerer, Michael Quintel, Scott Morley, Indalecio Moran, Francisco Parrilla, Andrea Costamagna, Marco Gaudiosi and Alain Combes. Critical Care; February 10, 2016, 20:36.)