Kalatoudis Haris, Nikhil Meena, Zeid Fuad, Shweihat Yousef
Pulmonary Department, Byrd Clinical Center, Marshall University School of Medicine, 1249 15th Street, Huntington, WV 25701, USA.
Internal Medicine Department, Marshall University School of Medicine, 1600 Medical Center Drive, Huntington, WV 25701, USA.
Case Rep Crit Care. 2017;2017:3092457. doi: 10.1155/2017/3092457. Epub 2017 Mar 7.
Patients who have acute respiratory distress syndrome (ARDS) with persistent air leaks have worse outcomes. Endobronchial valves (EBV) are frequently deployed after pulmonary resection in noncritically ill patients to reduce and eliminate bronchopleural fistulas (BPFs) with persistent air leak (PAL). Information regarding EBV placement in mechanically ventilated patients with ARDS and high volume persistent air leaks is rare and limited to case reports. We describe three cases where EBV placement facilitated endotracheal extubation in patients with severe respiratory failure on prolonged mechanical ventilation with BPFs. In each case, EBV placement led to immediate resolution of PAL. We believe endobronchial valve placement is a safe method treating persistent air leak with severe respiratory failure and may reduce days on mechanical ventilation.
患有急性呼吸窘迫综合征（ARDS）且存在持续性漏气的患者预后较差。在非危重症患者肺切除术后，常使用支气管内瓣膜（EBV）来减少并消除伴有持续性漏气（PAL）的支气管胸膜瘘（BPF）。关于在机械通气的ARDS患者且存在大量持续性漏气时放置EBV的信息很少，且仅限于病例报告。我们描述了3例病例，在这些病例中，EBV的放置有助于长期机械通气且伴有BPF的严重呼吸衰竭患者拔除气管插管。在每例病例中，EBV的放置都使PAL立即得到解决。我们认为，放置支气管内瓣膜是治疗伴有严重呼吸衰竭的持续性漏气的一种安全方法，且可能减少机械通气天数。
