Respiratory Dialysis

Emergency Use of Machine to Remove Dangerous Levels of Carbon Dioxide A machine called the Hemolung has been used under the United States Food and Drug Administration emergency use regulation to perform “respiratory dialysis” in order to save the life of a 31 year-old man with COPD. An April 3, 2015, story in the Baltimore Sun described the use of the Hemolung to remove carbon dioxide from the blood of a young man who developed respiratory failure as a result of an exacerbation (worsening of his COPD). He required a tube placed into his mouth and trachea (intubation) and the assistance of a breathing machine (ventilator) to support his failing lungs. Even with this treatment, his carbon dioxide (a normal waste product of our body) increased to dangerous levels. After discussing possible risks, his doctors obtained permission from the man and his family to use the Hemolung as an experimental treatment.
Picture of man with COPD who has high levels of carbon dioxide in blood going into  Hemolung machine (made by ALung) where most of carbon dioxide is removed. Blood is then returned in a tube back into man's circulation.

Picture of man with COPD who has high levels of carbon dioxide in blood going into Hemolung machine (made by ALung) where most of carbon dioxide is removed. Blood is then returned in a tube back into man’s circulation.

Here is how the Hemolung works: a plastic tube is place in a vein, and then blood is removed and passed through the machine which clears carbon dioxide and adds oxygen, and then the “good” blood is funneled back into the body using another vein. This process is similar to a dialysis machine removing toxins in the blood from someone who has kidney failure. At the present time the Hemolung is under review by the US Food and Drug Administration.  So far, the University of Pittsburg Medical Center and the University of Maryland Medical Center have obtained compassionate-use waivers for successful treatment of individuals with lung failure and high levels of carbon dioxide.  

Donald A. Mahler, M.D. is Emeritus Professor of Medicine at Geisel School of Medicine at Dartmouth in Hanover, New Hampshire. He works as a pulmonary physician at Valley Regional Hospital in Claremont, NH, where he is Director of Respiratory Services.