Arcaro Giovanna, Vianello Andrea
Respiratory Intensive Care Unit, City Hospital of Padova, Padova, Italy.
Respir Care. 2014 Dec;59(12):e197-200. doi: 10.4187/respcare.03184. Epub 2014 Jul 1.
Following unsuccessful treatment with noninvasive ventilation (NIV), patients requiring subsequent placement on invasive mechanical ventilation have a high mortality rate. Invasive mechanical ventilation is particularly problematic in patients with acute respiratory failure due to bronchiectasis exacerbation, as it is associated with a mortality rate of 19-35% and prolonged ICU stay. Here, we describe the successful management of a patient with exacerbated non-cystic fibrosis bronchiectasis using a pump-assisted venovenous system for extracorporeal CO2 removal (ProLUNG system) as an alternative to endotracheal intubation following NIV failure. The extracorporeal CO2 removal system proved to be safe and efficacious in this case study, and further studies focusing on its use in these types of cases seem warranted.
在无创通气（NIV）治疗失败后，需要随后接受有创机械通气的患者死亡率很高。有创机械通气在因支气管扩张加重导致急性呼吸衰竭的患者中尤其成问题，因为其死亡率为19%至35%，且患者在重症监护病房（ICU）的住院时间延长。在此，我们描述了一名非囊性纤维化支气管扩张加重患者的成功治疗过程，该患者在无创通气失败后，使用泵辅助静脉-静脉系统进行体外二氧化碳清除（ProLUNG系统）作为气管插管的替代方法。在本病例研究中，体外二氧化碳清除系统被证明是安全有效的，进一步针对此类病例使用该系统的研究似乎很有必要。
