Sonoo Tomohiro, Ohshima Kazuma, Kobayashi Hiroaki, Asada Toshifumi, Hiruma Takahiro, Doi Kento, Gunshin Masataka, Murakawa Tomohiro, Anraku Masaki, Nakajima Susumu, Nakajima Jun, Yahagi Naoki
Department of Emergency Medicine and Critical Care Medicine, Graduate School of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan,
J Artif Organs. 2014 Sep;17(3):281-4. doi: 10.1007/s10047-014-0776-y. Epub 2014 Jun 12.
This report highlights about one acute respiratory distress syndrome (ARDS) case after near-drowning resuscitated using extracorporeal membrane oxygenation (ECMO). Few cases have been reported about ECMO use for near-drowning and in most of these cases, ECMO was initiated within the first week. However, in our report, we would like to emphasize that seemingly irreversible secondary worsening of ARDS after nearly drowned patient was successfully treated by ECMO use more than 1 week after near-drowning followed by discharge without home oxygen therapy, social support, or any complication. This is probably due to sufficient lung rest for ventilator-associated lung injury during ECMO use. Based on our case's clinical course, intensive care unit physicians must consider ECMO even in the late phase of worsened ARDS after near-drowning.
本报告重点介绍了1例近乎溺水后使用体外膜肺氧合(ECMO)复苏成功的急性呼吸窘迫综合征(ARDS)病例。关于ECMO用于近乎溺水的报道较少,且在大多数此类病例中,ECMO在第一周内启动。然而,在我们的报告中,我们想强调的是,近乎溺水患者在溺水后1周多使用ECMO成功治疗后,ARDS出现看似不可逆的继发性恶化,随后出院,无需家庭氧疗、社会支持或任何并发症。这可能是由于在使用ECMO期间,肺得到了足够的休息,避免了呼吸机相关性肺损伤。基于我们病例的临床过程,重症监护病房的医生即使在近乎溺水后ARDS恶化的晚期也必须考虑使用ECMO。