Matsumoto T, Ueki K, Tamura S, Ideura H, Tsukada Y, Maezawa A, Nojima Y, Naruse T
The Third Department of Internal Medicine, Gunma University, School of Medicine, Maebashi, Japan.
Scand J Rheumatol. 2000;29(3):195-7. doi: 10.1080/030097400750002111.
We present here two patients whose near fatal respiratory distress was caused by pulmonary hemorrhage, and who were treated successfully by extracorporeal membrane oxygenation (ECMO). The underlying disease was anti-neutrophil cytoplasmic antibody (ANCA)-associated systemic vasculitis. They were initially treated with methylprednisolone pulse therapy along with cyclophosphamide. However, their respiratory failure progressed with a low PaO2/FiO2 ratio (< 100 mmHg) despite mechanical ventilation, and ECMO was initiated. After several days, the pulmonary hemorrhage subsided, and the patients were weaned successfully from ECMO. We suggest that ECMO may be used to manage life-threatening pulmonary hemorrhage in patients suffering from ANCA-associated systemic vasculitis.
我们在此报告两名患者，他们因肺出血导致近乎致命的呼吸窘迫，并通过体外膜肺氧合（ECMO）成功治疗。潜在疾病为抗中性粒细胞胞浆抗体（ANCA）相关性系统性血管炎。他们最初接受了甲泼尼龙冲击疗法及环磷酰胺治疗。然而，尽管进行了机械通气，他们的呼吸衰竭仍在进展，动脉血氧分压/吸入氧分数值（PaO2/FiO2）较低（<100 mmHg），于是启动了ECMO。数天后，肺出血消退，患者成功脱离ECMO。我们建议，ECMO可用于治疗ANCA相关性系统性血管炎患者危及生命的肺出血。
