The Novalung product family enables therapies for lung failure that are adapted to specific indications. In short, Novalung products can replace or reduce invasive mechanical ventilation with therapies tailored to the needs of each patient. The Novalung platform performs any level of CO2 removal and oxygenation in acute respiratory failure / AECOPD.

“Novalung’s lung support therapies can be dosed as required in order to individualize to a patient’s specific needs, which is a very significant clinical benefit.”

Thomas Bein, MD
University of Regensburg, Medical Center

  • “Mechanical ventilation is a life-saving therapy that can kill the lung.”1
  • Ventilation using positive pressure is never physiological.
  • IMV triggers cascades of pathophysiological processes which can cause additional lung damage (VALI/VILI)
  • Under mechanical ventilation, the breathing muscles begin to degenerate within a very short space of time (Ventilator Induced Diaphragm Dysfunction, VIDD)
  • Prevention of intubation is the only protection from ventilation-induced lung damage
  • The aim of the concept of ventilation providing lung protection is to keep the strain on the lungs during IMV as low as possible.

NOVALUNG THERAPIES PAVE THE WAY
TO REAL LUNG PROTECTION

Relief to the respiratory system is provided, and ventilation settings (tidal volume, respiratory rate, and respiratory pressure) are de-escalated. The membrane ventilator “breathes” on behalf of the patient outside the patient’s body and assists the native lung with some of the gas exchange work. The lung is given time to heal. Extracorporeal CO2 removal, which reduces the need for mechanical ventilation for the patient, can potentially prevent the side effects of mechanical ventilation altogether.2 If initiated early on, interventional lung support (iLA therapy) can prevent intubation.3,4

1 Pesenti A. Crit Care Med 2010; 38 (Suppl): S549-S554
2 Muellenbach RM et al. Eur J Anaesthesiol 2008;25:897-904
3 Kluge S et al. Intensive Care Med 2012; 38(10):1632-1639
4 Brederlau J et al. Eur Respir J 2012; 40(3):783-785

EXTRACORPOREAL BLOOD FLOW: AS HIGH
AS NECESSARY, AS LOW AS POSSIBLE.5,6

  • In addition to or as an alternative to ventilation strategies providing lung protection – enables (ultra)protective ventilation
  • Up to 25% of CO2 production can be removed. The lung is given time to heal.7
  • In a similar way to renal replacement therapy, extrapulmonary partial CO2 removal requires low blood flow rates and relatively small cannulas. The effectiveness of CO2 removal is primarily controlled by the flow rate of the sweepgas and depends on the CO2 partial pressure gradient.
  • Under mechanical ventilation, the breathing muscles begin to degenerate within a very short space of time (Ventilator Induced Diaphragm Dysfunction, VIDD)
  • Support weaning
  • Avoid intubation in borderline indications

PARTIAL CO2 REMOVAL WITH BLOOD
FLOWS <800ML/MIN

  • Supports gas exchange and compensates failure of the breathing pump. Up to 25% of CO2 production can be removed.7 The lung is given time to heal.
  • Supports oxygenation by simply increasing the extrapulmonary blood flow
  • Avoiding of intubation in case of intolerance to NIV
  • Shortening of IMV duration where intubation was unavoidable
  • Enabling and accelerating weaning from IMV
  • Reduction of analgo sedation
  • Reduction of tube-associated side effects (VALI/ VILI/VAP/VIDD).
  • Reduction of breathing load
  • Compensation of breathing pump failure through partial adoption of pulmonary function

CO2 REMOVAL AND OXYGENATION WITH
BLOOD FLOWS OF 800-3000 ML/MIN

  • Reduction in mortality by 50% in severe H1N1 influenza A infections.8
  • Immediate improvement in oxygenation and rapid correction of hypoxemia
  • Short-term support by means of extracorporeal gas exchange in patients with acute, reversible respiratory failure
  • “Bridge to transplant” in patients with irreversible respiratory failure
  • For patients where oxygenation or ventilation is difficult to maintain using conventional lungprotective ventilation.9,10
  • To gain valuable time so that adjuvant therapies (e.g., antibiotics) can start to work and lung function can recover.10

5 Parekh M. et al., (2018) Extracorporeal Membrane Oxygenation for ARDS: Optimization of Lung Protective Ventilation. Respiratory Care 63(9):1180-1188.
6 Schmidt M. et al., (2015)
Extracorporeal gas exchange for acute respiratory failure in adult patients: a systematic review. Critical Care 19(1):99.
7
Terragni P et.al. Curr Opin Crit Care 2012 Feb; 18(1):93-98.
8 Noah MA et al. JAMA 2011; 306(15):1659-1668.
9 Tiruvoipati R et al. J Crit Care 2012; 27(2):192-198.
10 Peek GJ et al. Lancet 2009; 374(9698):1351-1363.

INFORMATION

  • The iLA Membrane Ventilator “breathes” on behalf of the patient outside the patient’s body and assists the native lung with some of the gas exchange work.
  • Arterio-venous vascular access, the gas exchange capacity is controlled via the sweepgas flow
  • Sufficient CO2 removal11
  • Extremely low flow resistance
  • Application period up to 29 days

11 Hommel M. et al.,(2008) Bronchial fistulae in ARDS patients: management with an extracorporeal lung assist device, The European Respiratory Journal 32(6): 1652–1655.

INDICATIONS12

  • All clinical situations in which sufficient gas exchange, especially sufficient CO2 removal, cannot be achieved in spite of strict ventilation providing lung protection.
  • All clinical situations in which spontaneous breathing requires an additional effort from the patient, or where the breathing pump is about to fatigue.
  • For potential breathing support during ventilation weaning

12 Camporota L. et al., (2016) Current Applications for the Use of xtracorporeal CarbonDioxide Removal in Critically Ill Patients, BioMed Research International, Volume 2016.

Reliable effectiveness – effective CO₂ removal;
iLA av Registry internal Novalung n=600 patients

Unpublished data based on Novalung registry. For futher information please contact Xenios AG