Tully R P, Hopley N, Lawrence G
Intensive Care Medicine and Anaesthesia Royal Oldham Hospital Oldham UK.
Intensive Care Medicine Royal Oldham Hospital Oldham UK.
Anaesth Rep. 2020 Sep 25;8(2):e12072. doi: 10.1002/anr3.12072. eCollection 2020 Jul-Dec.
We present a patient with severe COVID-19 pneumonitis; poor respiratory compliance; dangerously high ventilator pressures; and hypercapnia refractory to conventional treatment including low tidal volume ventilation, neuromuscular blockade and prone position ventilation. Extracorporeal carbon dioxide removal was used as a rescue therapy to facilitate safer ventilator pressures and arterial partial pressures of carbon dioxide. After 6 days of treatment, the patient had improved to the extent that the extracorporeal support was able to be weaned and the patient was decannulated from the device. Following a prolonged respiratory wean, the patient was subsequently discharged from the intensive care unit and then from the hospital to home with no adverse events related to the therapy.
我们报告了一名患有严重新型冠状病毒肺炎（COVID-19）肺炎的患者，其呼吸顺应性差，呼吸机压力极高且危险，存在对包括低潮气量通气、神经肌肉阻滞剂和俯卧位通气在内的传统治疗无效的高碳酸血症。采用体外二氧化碳清除作为挽救治疗，以实现更安全的呼吸机压力和动脉血二氧化碳分压。经过6天的治疗，患者病情改善到可以撤下体外支持并拔除该设备插管的程度。经过长时间的呼吸脱机过程，患者随后从重症监护病房出院，然后从医院回家，未发生与该治疗相关的不良事件。
