Stirling S L, Cordingley J J, Hunter D N, Griffiths M J, Wort S J, Evans T W, Finney S J
Adult Intensive Care Unit, Royal Brompton Hospital, Sydney Street, London, UK.
Thorax. 2009 Aug;64(8):726-7. doi: 10.1136/thx.2008.098731.
The case histories are presented of three adults who had severe hypercapnic acidosis despite mechanical ventilation with what were considered to be injurious tidal volumes and airway pressures. The use of a percutaneously inserted arteriovenous extracorporeal carbon dioxide removal (AV-ECCO(2)R) device facilitated a dramatic reduction in the amount of ventilatory support required, achieving a "lung-protective" level. Two patients survived to hospital discharge. One patient died after it became apparent that her late-stage interstitial lung disease was unresponsive to immunosuppression. AV-ECCO(2)R may be a useful strategy in facilitating lung-protective ventilation.
本文介绍了三名成年人的病例，尽管使用了被认为具有伤害性的潮气量和气道压力进行机械通气，他们仍出现了严重的高碳酸血症酸中毒。使用经皮插入的动静脉体外二氧化碳清除（AV-ECCO₂R）装置有助于大幅减少所需的通气支持量，达到“肺保护性”水平。两名患者存活至出院。一名患者在发现她的晚期间质性肺病对免疫抑制无反应后死亡。AV-ECCO₂R可能是促进肺保护性通气的一种有用策略。
