Our Summary

This study discusses the use of a medical technique called extracorporeal lung support (ECLS) in patients with severe lung disease (end-stage lung emphysema) who are undergoing a specific type of surgery (lung volume reduction surgery or LVRS). ECLS is a way of providing oxygen to the body when the lungs can’t function properly. The authors looked at a specific type of ECLS called veno-venous ECLS (VV ECLS) in patients who had high levels of carbon dioxide in their blood (severe hypercapnia) due to chronic respiratory failure.

The study involved 125 patients who were having LVRS. Some of these patients (65) had severe hypercapnia and were given VV ECLS either before or during their surgery, and then also after their surgery. The other 60 patients didn’t have severe hypercapnia and served as a control group.

The researchers found that, for the patients with severe hypercapnia, using VV ECLS was effective and well-tolerated. It increased the safety of the surgery, helped reduce the need for intensive breathing support, and lowered the rate of complications after surgery. These patients were considered to be at high risk for LVRS, so these results were promising. The researchers also found that, after surgery, both groups of patients saw improvements in their quality of life, ability to exercise, and breathlessness symptoms.

FAQs

  1. What is extracorporeal lung support (ECLS) and how does it function?
  2. What is veno-venous ECLS (VV ECLS) and why was it used in patients with severe hypercapnia?
  3. What were the findings of the study regarding the use of VV ECLS in patients with severe hypercapnia undergoing lung volume reduction surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lung surgery is to follow post-operative care instructions closely. This may include activities to avoid, medications to take, and exercises to do to improve lung function. It’s important to attend follow-up appointments and communicate any concerns or changes in symptoms to your healthcare team. By following these instructions, you can help ensure a successful recovery and improve your overall lung health.

Suitable For

Patients who are typically recommended for lung surgery include those with severe lung disease such as end-stage lung emphysema, chronic respiratory failure with high levels of carbon dioxide in the blood, and those at high risk for specific types of surgeries like lung volume reduction surgery. Patients who are experiencing difficulty breathing, reduced quality of life, and impaired exercise capacity due to their lung condition may also be recommended for lung surgery. Additionally, patients who have tried other treatments and interventions without success may be considered for lung surgery as a last resort option.

Timeline

Before lung surgery:

  1. Patient is diagnosed with severe lung disease (end-stage lung emphysema).
  2. Patient is evaluated for surgery, including assessing their lung function and overall health.
  3. For patients with severe hypercapnia, VV ECLS may be considered as a treatment option before surgery to help manage their condition.
  4. Patient undergoes pre-operative preparation, including discussions with the surgical team and anesthesiologist.

During and after lung surgery:

  1. For patients with severe hypercapnia, VV ECLS may be used during and after surgery to provide oxygen support.
  2. Surgery is performed, in this case LVRS, to improve lung function and quality of life.
  3. Post-operative care is provided, including monitoring for complications, pain management, and rehabilitation.
  4. Patients may experience improvements in their quality of life, exercise capacity, and symptoms of breathlessness after surgery.
  5. Follow-up appointments are scheduled to monitor recovery and assess long-term outcomes.

What to Ask Your Doctor

  1. What is the purpose of using extracorporeal lung support (ECLS) in my case?
  2. How will VV ECLS benefit me during and after lung surgery?
  3. What are the potential risks or complications associated with using VV ECLS during surgery?
  4. How long will I need to be on VV ECLS before and after surgery?
  5. Will I need any additional monitoring or care while on VV ECLS?
  6. How will VV ECLS impact my recovery process following lung surgery?
  7. What are the expected outcomes or improvements I can anticipate after undergoing LVRS with VV ECLS?
  8. Are there any alternative treatments or options I should consider before proceeding with VV ECLS during surgery?
  9. How experienced is the medical team in using VV ECLS for patients undergoing LVRS?
  10. Are there any long-term effects or considerations I should be aware of if I undergo LVRS with VV ECLS?

Reference

Authors: Akil A, Ziegeler S, Reichelt J, Lavae-Mokhtari M, Freermann S, Semik M, Fichter J, Rehers S, Dickgreber NJ, Richter L, Ernst EC, Fischer S. Journal: ASAIO J. 2020 Aug;66(8):952-959. doi: 10.1097/MAT.0000000000001108. PMID: 32740358