Background
Life-threatening acute lung injury due to combat and/or terror attacks is associated with high mortality. The successful management
includes the use of “rescue” extracorporeal lung assist and early transport by aeromedical evacuation teams.
Aims
Description of the pre-hospital support of a severely injured soldier with a pumpless extracorporeal arterio-venous lung assist
in critical hypercapnia/hypoxemia.
Method
A British soldier suffered from severe gunshot injuries to the chest and abdomen in Afghanistan. After traumatic pneumonectomy,
he developed critical hypercapnia/hypoxemia. He was mechanically ventilated and supported with a pumpless interventional extracorporeal
lung assist (iLA, Novalung, Talheim, Germany) and transferred to Germany.
Results
A sufficient CO2 extraction and improvement in oxygenation enabled the safe transportation and lung protective ventilation. Weaning from mechanical
ventilation was promoted by the application of a new neurally adjusted ventilatory assist (NAVA). The patient recovered, and
he left Germany in stable condition.
Conclusion
Novel techniques in extracorporeal lung assist and in ventilatory support may help save lives even in disaster medicine.
Keywords Traumatic lung injury - Extracorporeal lung assist - Disaster medicine - Neurally adjusted ventilatory assist