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低流量静脉-静脉体外二氧化碳清除在重症哮喘患者管理中的应用:一例病例报告

Low-flow veno-venous extracorporeal carbon dioxide removal in the management of severe status asthmatics: a case report.

作者信息

Tiruvoipati Ravindranath, Haji Kavi, Gupta Sachin, Braun Gary, Carney Ian, Botha John

机构信息

Department of Intensive Care Medicine, Frankston Hospital, Melbourne, Vic., Australia.

School of Public Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia.

出版信息

Clin Respir J. 2016 Sep;10(5):653-6. doi: 10.1111/crj.12252. Epub 2015 Jan 15.

Abstract

Status asthmaticus is a life-threatening condition that requires intensive care management. Most of these patients have severe hypercapnic acidosis that requires lung protective mechanical ventilation. A small proportion of these patients do not respond to conventional lung protective mechanical ventilation or pharmacotherapy. Such patients have an increased mortality and morbidity. Successful use of extracorporeal membrane oxygenation (ECMO) is reported in such patients. However, the use of ECMO is invasive with its associated morbidity and is limited to specialised centres. In this report, we report the use of a novel, minimally invasive, low-flow extracorporeal carbon dioxide removal device in management of severe hypercapnic acidosis in a patient with life threatening status asthmaticus.

摘要

哮喘持续状态是一种危及生命的情况,需要重症监护管理。这些患者中的大多数患有严重的高碳酸血症性酸中毒,需要进行肺保护性机械通气。这些患者中有一小部分对传统的肺保护性机械通气或药物治疗无反应。这类患者的死亡率和发病率会增加。据报道,此类患者成功使用了体外膜肺氧合(ECMO)。然而,ECMO的使用具有侵入性且伴有相关并发症,并且仅限于专业中心。在本报告中,我们报告了在一名患有危及生命的哮喘持续状态的患者中,使用一种新型的、微创的、低流量体外二氧化碳清除装置来治疗严重的高碳酸血症性酸中毒。

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