Redel A, Ritzka M, Kraus S, Philipp A, Schlitt H-J, Graf B, Bein T
Klinik für Anästhesiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
Klinik für Chirurgie, Universitätsklinikum Regensburg, Regensburg, Deutschland.
Anaesthesist. 2016 Dec;65(12):925-928. doi: 10.1007/s00101-016-0244-6. Epub 2016 Nov 28.
We report a patient with chest trauma who was admitted to the ICU after surgery. As he fulfilled protocol-based criteria, he was extubated 7 days after admission. However, despite intermittent non-invasive ventilation, the patient had to be re-intubated on day 10 owing to progressive hypercapnia. We decided to support the patient with a mid-flow veno-venous extracorporeal carbon dioxide removal (ECCO‑R) system instead of a tracheotomy. Sufficient CO removal was established with a blood flow of 1.5 l/min and the patient was successfully extubated within a few hours. After 5 days of ECCO‑R the patient could be weaned and transferred to a general ward in a stable condition.
我们报告了一名胸部创伤患者，术后入住重症监护病房（ICU）。由于他符合基于方案的标准，入院7天后拔管。然而，尽管进行了间歇性无创通气，但患者在第10天因进行性高碳酸血症不得不再次插管。我们决定用中流量静脉-静脉体外二氧化碳清除（ECCO-R）系统支持该患者，而不是进行气管切开术。以1.5升/分钟的血流量实现了充分的二氧化碳清除，患者在数小时内成功拔管。经过5天的ECCO-R治疗，患者可以撤机并以稳定状态转至普通病房。
