Ray Juliet J, Straker Richard J, Hart Valerie J, Meizoso Jonathan P, Schulman Carl I, Loebe Matthias, Ghodsizad Ali
DeWitt Daughtry Family Department of Surgery, Miami, Florida.
Miami Transplant Institute, University of Miami Miller School of Medicine, Miami, Florida.
J Burn Care Res. 2018 Jun 13;39(4):640-644. doi: 10.1093/jbcr/irx021.
Burn injury results in a severe systemic inflammatory response which is associated with the development of acute respiratory distress syndrome (ARDS), even without associated inhalation injury. Venous-venous extracorporeal membrane oxygenation (VV-ECMO) has been implemented in various cases of ARDS to provide support and allow for protective lung ventilation strategies. We report the case of a 27-year-old man presenting with a 60% total body surface area partial thickness burn who developed refractory ARDS with Murray Score of 3.75. ECMO was initiated on hospital day 9 for a total of 10 days with concurrent lung-protective ventilation. He subsequently recovered and was discharged on hospital day 48. ECMO should be considered as an adjunctive strategy in burn patients without inhalation injury to minimize ventilator-induced lung injury when high levels of support are needed to achieve adequate ventilation in patients with ARDS.
烧伤会导致严重的全身炎症反应，即使没有吸入性损伤，也与急性呼吸窘迫综合征（ARDS）的发生有关。静脉-静脉体外膜肺氧合（VV-ECMO）已应用于各种ARDS病例，以提供支持并允许采用肺保护性通气策略。我们报告了一例27岁男性患者，其全身60%体表面积为浅度烧伤，并发难治性ARDS，Murray评分为3.75。患者于住院第9天开始接受ECMO治疗，共持续10天，同时采用肺保护性通气。他随后康复，并于住院第48天出院。对于无吸入性损伤的烧伤患者，当需要高水平支持以实现ARDS患者的充分通气时，应考虑将ECMO作为辅助策略，以尽量减少呼吸机诱发的肺损伤。
