Pumpless extracorporeal carbon dioxide removal for life-threatening asthma

被引:56
作者
Elliot, Stuart C. [1 ]
Paramasivam, Kumar [1 ]
Oram, John [1 ]
Bodenham, Andrew R. [1 ]
Howell, Simon J. [1 ]
Mallick, Abhiram [1 ]
机构
[1] Leeds Gen Infirm, Leeds Teaching Hosp NHS Trust, Dept Anaesthet, Leeds, W Yorkshire, England
关键词
extracorporeal carbon dioxide removal; Novalung; acute severe asthma; mechanical ventilation; hypercapnia;
D O I
10.1097/01.CCM.0000257462.04514.15
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objective: To report the use of pumpless extracorporeal carbon dioxide removal in two cases of acute severe asthma. Design: Case reports. Setting: Adult general intensive care unit, Leeds General Infirmary, Leeds, UK. Patients: A 74-yr-old male and 52-yr-old female with life-threatening asthma developed progressive hypercapnia and severe acidosis that proved nonresponsive to all other therapies. Intervention: Initiation of extracorporeal arteriovenous carbon dioxide removal using the Novalung device (Novalung GmbH, Lotzenacker 3, D-72379 Hechingen, Germany). Main Results: The addition of extracorporeal carbon dioxide removal to mechanical ventilation corrected hypercapnia and acidosis, allowing reduction of other supportive measures. In both cases, adequate gas exchange was maintained until their underlying condition improved sufficiently for device removal. The two patients were subsequently weaned from mechanical ventilation and made a full recovery. Conclusions: Extracorporeal carbon dioxide removal proved to be a valuable adjunct to mechanical ventilation and other medical treatment.
引用
收藏
页码:945 / 948
页数:4
相关论文
共 8 条
[1]   A new pumpless extracorporeal interventional lung assist in critical hypoxemia/hypercapnia [J].
Bein, T ;
Weber, F ;
Philipp, A ;
Prasser, C ;
Pfeifer, M ;
Schmid, FX ;
Butz, B ;
Birnbaum, D ;
Taeger, K ;
Schlitt, HJ .
CRITICAL CARE MEDICINE, 2006, 34 (05) :1372-1377
[2]  
KRISHNAN V, 2006, IN PRESS AM J RESP C
[3]  
Leiba A, 2003, ISRAEL MED ASSOC J, V5, P600
[4]   High survival rate in 122 ARDS patients managed according to a clinical algorithm including extracorporeal membrane oxygenation [J].
Lewandowski, K ;
Rossaint, R ;
Pappert, D ;
Gerlach, H ;
Slama, KJ ;
Weidemann, H ;
Frey, DJM ;
Hoffmann, O ;
Keske, U ;
Falke, KJ .
INTENSIVE CARE MEDICINE, 1997, 23 (08) :819-835
[5]   Acute severe asthma [J].
McFadden, ER .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2003, 168 (07) :740-759
[6]   Management of mechanical ventilation in acute severe asthma: practical aspects [J].
Oddo, M ;
Feihl, F ;
Schaller, MD ;
Perret, C .
INTENSIVE CARE MEDICINE, 2006, 32 (04) :501-510
[7]   The pulmonary physician in critical care .12: Acute severe asthma in the intensive care unit [J].
Phipps, P ;
Garrard, CS .
THORAX, 2003, 58 (01) :81-88
[8]   RISK-FACTORS FOR MORBIDITY IN MECHANICALLY VENTILATED PATIENTS WITH ACUTE SEVERE ASTHMA [J].
WILLIAMS, TJ ;
TUXEN, DV ;
SCHEINKESTEL, CD ;
CZARNY, D ;
BOWES, G .
AMERICAN REVIEW OF RESPIRATORY DISEASE, 1992, 146 (03) :607-615