使用体外二氧化碳抽吸清除装置治疗重度创伤性脑损伤和急性呼吸窘迫综合征
Management of severe traumatic brain injury and acute respiratory distress syndrome using pumped extracorporeal carbon dioxide removal device.
作者信息
Martindale Tim, McGlone Phillip, Chambers Robert, Fennell Jon
机构信息
Intensive Care Medicine and Anaesthesia, Department of Critical Care, University Hospital Southampton, UK.
出版信息
J Intensive Care Soc. 2017 Feb;18(1):66-70. doi: 10.1177/1751143716676821. Epub 2016 Oct 25.
Abstract
The effects of a high carbon dioxide on cerebral perfusion and intracranial pressure are well known. We report the case of a man who presented after with a severe traumatic brain injury including intracranial and extradural haemorrhage. Neuroprotective ventilation was impossible without supramaximal tidal volumes due to a combination of chest trauma and severe bronchospasm. A pump driven Novalung iLA active® system was inserted to achieve both ARDSnet ventilation and a lowering of intracranial pressure. To our knowledge, this is the first time this system has been used to this effect. The patient went on to make a good recovery.
摘要
高二氧化碳对脑灌注和颅内压的影响是众所周知的。我们报告了一例严重创伤性脑损伤患者，包括颅内和硬膜外出血。由于胸部创伤和严重支气管痉挛，在不使用超大潮气量的情况下无法进行神经保护性通气。插入了一个泵驱动的Novalung iLA active®系统，以实现ARDSnet通气并降低颅内压。据我们所知，这是该系统首次用于此目的。患者随后恢复良好。
相似文献
1
Management of severe traumatic brain injury and acute respiratory distress syndrome using pumped extracorporeal carbon dioxide removal device.使用体外二氧化碳抽吸清除装置治疗重度创伤性脑损伤和急性呼吸窘迫综合征
J Intensive Care Soc. 2017 Feb;18(1):66-70. doi: 10.1177/1751143716676821. Epub 2016 Oct 25.
2
Extracorporeal CO2 removal.体外二氧化碳清除
Contrib Nephrol. 2010;165:185-196. doi: 10.1159/000313758. Epub 2010 Apr 20.
3
Extracorporeal lung membrane provides better lung protection than conventional treatment for severe postpneumonectomy noncardiogenic acute respiratory distress syndrome.对于严重的肺切除术后非心源性急性呼吸窘迫综合征，体外肺膜氧合比传统治疗提供更好的肺保护。
J Thorac Cardiovasc Surg. 2008 Jun;135(6):1362-71. doi: 10.1016/j.jtcvs.2007.08.074.
4
Extracorporeal decarboxylation in patients with severe traumatic brain injury and ARDS enables effective control of intracranial pressure.重度创伤性脑损伤和急性呼吸窘迫综合征患者的体外脱羧可有效控制颅内压。
Crit Care. 2015 Oct 30;19:381. doi: 10.1186/s13054-015-1088-1.
5
Pre-emptive Novalung-assisted carbon dioxide removal in a patient with chest, head and abdominal injury.在一名胸部、头部和腹部受伤患者中进行的预先诺瓦肺辅助二氧化碳清除。
Anaesthesia. 2008 Jul;63(7):767-70. doi: 10.1111/j.1365-2044.2008.05484.x.
6
Safety and Efficacy of Combined Extracorporeal CO2 Removal and Renal Replacement Therapy in Patients With Acute Respiratory Distress Syndrome and Acute Kidney Injury: The Pulmonary and Renal Support in Acute Respiratory Distress Syndrome Study.急性呼吸窘迫综合征和急性肾损伤患者联合体外二氧化碳清除与肾脏替代治疗的安全性和有效性：急性呼吸窘迫综合征的肺肾支持研究
Crit Care Med. 2015 Dec;43(12):2570-81. doi: 10.1097/CCM.0000000000001296.
7
Agreement Between Arterial Carbon Dioxide Levels With End-Tidal Carbon Dioxide Levels and Associated Factors in Children Hospitalized With Traumatic Brain Injury.动脉二氧化碳水平与儿童创伤性脑损伤住院患者呼末二氧化碳水平的一致性及其相关因素。
JAMA Netw Open. 2019 Aug 2;2(8):e199448. doi: 10.1001/jamanetworkopen.2019.9448.
8
Extracorporeal carbon dioxide removal using the Novalung in a patient with intracranial bleeding.在一名颅内出血患者中使用诺瓦肺进行体外二氧化碳清除。
Anaesthesia. 2007 Jan;62(1):72-4. doi: 10.1111/j.1365-2044.2006.04863.x.
9
Pumpless extracorporeal removal of carbon dioxide combined with ventilation using low tidal volume and high positive end-expiratory pressure in a patient with severe acute respiratory distress syndrome.在一名严重急性呼吸窘迫综合征患者中，采用低潮气量和高呼气末正压通气联合无泵体外二氧化碳清除技术。
Anaesthesia. 2009 Feb;64(2):195-8. doi: 10.1111/j.1365-2044.2008.05735.x.
10
Control of Respiratory Drive and Effort in Extracorporeal Membrane Oxygenation Patients Recovering from Severe Acute Respiratory Distress Syndrome.体外膜肺氧合治疗的严重急性呼吸窘迫综合征恢复患者呼吸驱动与呼吸努力的控制
Anesthesiology. 2016 Jul;125(1):159-67. doi: 10.1097/ALN.0000000000001103.
引用本文的文献
1
Management of traumatic brain injury and acute respiratory distress syndrome-What evidence exists? A scoping review.创伤性脑损伤与急性呼吸窘迫综合征的管理——现有哪些证据？一项范围综述。
J Intensive Care Soc. 2025 Jan 18;26(2):205-222. doi: 10.1177/17511437241311398. eCollection 2025 May.
本文引用的文献
1
Early initiation of extracorporeal membrane oxygenation improves survival in adult trauma patients with severe adult respiratory distress syndrome.早期启动体外膜肺氧合可提高患有严重成人呼吸窘迫综合征的成年创伤患者的生存率。
J Trauma Acute Care Surg. 2016 Aug;81(2):236-43. doi: 10.1097/TA.0000000000001068.
2
Update on the role of extracorporeal CO₂ removal as an adjunct to mechanical ventilation in ARDS.体外二氧化碳清除作为急性呼吸窘迫综合征机械通气辅助手段的作用进展
Crit Care. 2015 Mar 16;19(1):117. doi: 10.1186/s13054-015-0799-7.
3
Extracorporeal membrane oxygenation use in patients with traumatic brain injury.体外膜肺氧合在创伤性脑损伤患者中的应用。
Perfusion. 2015 Jul;30(5):407-9. doi: 10.1177/0267659114554327. Epub 2014 Oct 13.
4
The effect of pumpless extracorporeal CO2 removal on regional perfusion of the brain in experimental acute lung injury.体外无泵 CO2 去除对实验性急性肺损伤时脑区域性灌注的影响。
J Neurosurg Anesthesiol. 2013 Jul;25(3):324-9. doi: 10.1097/ANA.0b013e3182905e6a.
5
Prolonged heparin-free extracorporeal membrane oxygenation in multiple injured acute respiratory distress syndrome patients with traumatic brain injury.多发伤合并创伤性脑损伤的急性呼吸窘迫综合征患者行肝素免费体外膜肺氧合治疗时间延长。
J Trauma Acute Care Surg. 2012 May;72(5):1444-7. doi: 10.1097/TA.0b013e31824d68e3.
6
Acute lung injury in patients with severe brain injury: a double hit model.严重脑损伤患者的急性肺损伤：双重打击模型。
Neurocrit Care. 2009 Dec;11(3):417-26. doi: 10.1007/s12028-009-9242-8.
7
Role of intracranial pressure values and patterns in predicting outcome in traumatic brain injury: a systematic review.颅内压值及模式在预测创伤性脑损伤预后中的作用：一项系统评价
Neurocrit Care. 2007;6(2):104-12. doi: 10.1007/s12028-007-0012-1.
8
The development of acute lung injury is associated with worse neurologic outcome in patients with severe traumatic brain injury.急性肺损伤的发生与重度创伤性脑损伤患者较差的神经学预后相关。
J Trauma. 2003 Jul;55(1):106-11. doi: 10.1097/01.TA.0000071620.27375.BE.
9
Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome.与传统潮气量相比，采用较低潮气量对急性肺损伤和急性呼吸窘迫综合征进行通气治疗。
N Engl J Med. 2000 May 4;342(18):1301-8. doi: 10.1056/NEJM200005043421801.
Zotero 插件