Afterword: Bottom–Line Status Report: CAN Current Trends in Membrane Gas Transfer Technology Lead to an Implantable Intrathoracic Artificial Lung?

Abstract: For at least 170 years, attempts have been made to alleviate inadequate gas exchange of patients with respiratory failure. Major milestones in the struggle to assist failing natural lungs to achieve adequate blood gas exchange include utilization of oxygen inhalation therapy, mechanical ventilatory assistance, and development of both extracorporeal and intracorporeal mechanical blood gas exchangers. Current state–of–the–art technology related to mechanical membrane blood gas exchangers has produced highly efficient gas transfer membranes and designs capable of replacing all the gas transfer functions of the natural lungs by a mechanical oxygenator–CO₂ remover that can fit into a unilateral thoracic cavity. The possibility thus exists of moving extracorporeal mechanical blood oxygenators into the body as an implantable intracorporeal artificial lung. Problems impeding the development of an implantable, intrathoracic artificial lung have been identified, and at least partially successful attempts to solve them have been reported. The conclusion drawn is that the appropriate answer to the question posed in the title of this communication is affirmative. Reasons for this conclusion include the persistent widespread major need for better relief from respiratory failure, the advanced state–of–the–art of mechanical blood gas exchanger technology, and the incompletely tapped ingenuity of the human mind.