Humans can’t live without lungs. And yet for 48 hours, in a surgical suite at Northwestern University, a 33-year-old man lived with an empty cavity in his chest where his lungs used to be. He was kept alive by a custom-engineered artificial device that represented a desperate last-ditch effort by his doctors. The custom hardware solved a physiological puzzle that has made bilateral pneumonectomy, the removal of both lungs, extremely risky before now.
The artificial lung system was built by the team of Ankit Bharat, a surgeon and researcher at Northwestern. It successfully kept a critically ill patient alive long enough to enable a double lung transplant, temporarily replacing his entire pulmonary system with a synthetic surrogate. The system creates a blueprint for saving people previously considered beyond hope by transplant teams.
Melting lungs
The patient, a once-healthy 33-year-old, arrived at the hospital with Influenza B complicated by a secondary, severe infection of Pseudomonas aeruginosa, a bacterium that in this case proved resistant even to carbapenems—our antibiotics of last resort. This combination of infections triggered acute respiratory distress syndrome (ARDS), a condition where the lungs become so inflamed and fluid-filled that oxygen can no longer reach the blood.
In this case, the infections were necrotizing—the cells in the lungs were dying, turning his lung tissue into a liquid. The surgeons faced a seemingly impossible choice. The patient needed a transplant to survive, but he was in refractory septic shock. His kidneys were shutting down, and his heart was failing to the point where it completely stopped shortly after hospital admission. The doctors had to bring him back with CPR.
He was too sick for a transplant, yet the very organs that needed replacing were the source of the infection fueling his decline. “When the infection is so severe that the lungs are melting, they’re irrecoverably damaged,” Bharat explained. “That’s when patients die.”