Umei Nao, Ichiba Shingo
Department of Surgical Intensive Care Medicine, Nippon Medical School Hospital, Tokyo, Japan.
Case Rep Crit Care. 2017;2017:9437452. doi: 10.1155/2017/9437452. Epub 2017 Feb 23.
The mortality rate for respiratory failure resulting from obesity hypoventilation syndrome is high if it requires ventilator management. We describe a case of severe acute respiratory failure resulting from obesity hypoventilation syndrome (BMI, 60.2 kg/m) successfully treated with venovenous extracorporeal membrane oxygenation (VV-ECMO). During ECMO management, a mucus plug was removed by bronchoscopy daily and 18 L of water was removed using diuretics, resulting in weight loss of 24 kg. The patient was weaned from ECMO on day 5, extubated on day 16, and discharged on day 21. The fundamental treatment for obesity hypoventilation syndrome in morbidly obese patients is weight loss. VV-ECMO can be used for respiratory support until weight loss has been achieved.
肥胖低通气综合征导致的呼吸衰竭若需呼吸机管理，死亡率很高。我们描述了一例由肥胖低通气综合征（体重指数，60.2kg/m）导致的严重急性呼吸衰竭病例，该病例通过静脉-静脉体外膜肺氧合（VV-ECMO）成功治愈。在ECMO管理期间，每天通过支气管镜清除黏液栓，并使用利尿剂排出18L水，体重减轻了24kg。患者在第5天脱离ECMO，第16天拔管，第21天出院。病态肥胖患者肥胖低通气综合征的根本治疗方法是减重。VV-ECMO可用于呼吸支持，直至实现减重。
