Isolated Lung Perfusion in the Management of Acute Respiratory Distress Syndrome

Acute respiratory distress syndrome (ARDS) is associated with high morbidity and mortality, and current management has a dramatic impact on healthcare resource utilization. While our understanding of this disease has improved, the majority of treatment strategies remain supportive in nature and are associated with continued poor outcomes. There is a dramatic need for the development and breakthrough of new methods for the treatment of ARDS. Isolated machine lung perfusion is a promising surgical platform that has been associated with the rehabilitation of injured lungs and the induction of molecular and cellular changes in the lung, including upregulation of anti-inflammatory and regenerative pathways. Initially implemented in an ex vivo fashion to evaluate marginal donor lungs prior to transplantation, recent investigations of isolated lung perfusion have shifted in vivo and are focused on the management of ARDS. This review presents current tenants of ARDS management and isolated lung perfusion, with a focus on how ex vivo lung perfusion (EVLP) has paved the way for current investigations utilizing in vivo lung perfusion (IVLP) in the treatment of severe ARDS.

Osteosarcoma with lung metastases

Osteosarcoma is the bone tumor that most commonly affects children and adolescents. Before the introduction of polychemotherapy > 90% of patients with osteosarcoma died from pulmonary metastases. Despite development of new protocols of therapy in 30–40% of patients the disease is recurrent, more than 80% of them detected pulmonary metastasis. In this review we discussed the problems of detection of metastatic lung lesions and current approaches of methods of detection and marking of small sized metastatic lung lesions. An additional option in the treatment of lung metastases is intraoperative isolated lung perfusion, surgical approaches of which were also discussed.

Metastatic lung disease in children with solid tumors: a historical excursion

The review article provides information about metastases of solid tumors in the lungs: from pathogenesis and the first experience of metastasectomy to a combined local method of therapeutic treatment. According to the literature, lung metastasectomy is part of the standard treatment for adults, but information about the surgical treatment of metastatic lesions in children remains poorly understood. As a rule, metastatic lesion accompanies the progression of the tumor process. Since the 1960s, methods of isolated lung perfusion have been developed, the results of which are reflected in a few articles, but most of the studies are aimed at exploring the possibilities of use and at the direct results of the implementation of this technique.