Artificial lung system
For the sickest acute respiratory distress syndrome (ARDS) patients, clinicians often rely on prolonged life support and time, hoping the lungs can recover. But in some cases, the lungs themselves become the source of relentless infection and inflammation, driving organ failure and leaving no path forward unless the diseased lungs can be removed and replaced. But in these scenarios the patients are also too unstable to go through removal and transplant in the same setting. That created a dilemma: taking out both lungs can stop the infectious source, but without lungs, the body also loses critical gas exchange and the normal circulatory buffering the lungs provide, placing the heart at risk of collapse or catastrophic instability.
To solve this problem, Dr. Bharat’s team designed a total artificial lung system intended to do more than oxygenate blood. The system was engineered to support circulation in the absence of lungs by helping maintain balanced blood flow through the heart, an essential requirement for survival after bilateral pneumonectomy (removal of both lungs). The design incorporated a flow-adaptive shunt that compensated for the loss of the lung’s blood vessel network, dual pathways to drain blood from the body and return oxygenated blood back to the heart.
Because an empty chest cavity can allow the heart to shift, the team used temporary internal supports, including saline-filled tissue expanders (breast implants) commonly used in reconstructive surgery, to help stabilize the heart’s position until transplantation.
“Just one day after we took out the lungs, his body started to get better because the infection was gone,” said Dr. Bharat.
Over the next 48 hours, the patient’s condition improved enough to proceed with transplantation. When donor lungs became available, the Northwestern Medicine team performed a double-lung transplant. More than two years later, the patient has returned to daily life with excellent lung function.
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