Department of Anesthesiology and Intensive Care, Medical University of Sofia, Sofia, Bulgaria.
Department of Anesthesiology and Intensive Care, Medical University of Sofia, Sofia, Bulgaria,
Blood Purif. 2019;48(4):382-384. doi: 10.1159/000502078. Epub 2019 Jul 29.
Acute respiratory distress syndrome (ARDS) is characterized by a widespread inflammation of the lungs, causing severe hypoxemia. Several mediators have been associated with it and almost all of them are small enough to be filtrated through a nanomembrane. We present a case report of a 41-year-old man with myasthenia gravis in remission; he developed ARDS caused by pneumonia. Although he performed well on both non-invasive and invasive mechanical ventilation, his oxygenation continued to deteriorate. As a last resort of treatment, we decided to apply nanomembrane-based apheresis to cleanse his plasma from the harmful inflammatory mediators. After 3 sessions of plasmapheresis, his condition improved and he was successfully weaned from mechanical ventilation. The obtained results gave us ground to assume that the removal of bioactive molecules can be a useful adjunct to protective mechanical ventilation in ARDS.
急性呼吸窘迫综合征（ARDS）的特征是肺部广泛炎症，导致严重的低氧血症。已经有几种介质与之相关，而且几乎所有这些介质都足够小，可以通过纳米膜进行过滤。我们报告了一例 41 岁的重症肌无力缓解期男性患者，他因肺炎导致 ARDS。尽管他在无创和有创机械通气方面表现良好，但他的氧合情况仍持续恶化。作为治疗的最后手段，我们决定应用基于纳米膜的血浆分离术，从他的血浆中清除有害的炎症介质。在进行了 3 次血浆置换后，他的病情得到改善，并成功地脱离了机械通气。获得的结果使我们有理由假设，清除生物活性分子可能是 ARDS 保护性机械通气的有用辅助手段。
