Unold Jason, Marshal Brandon, Sonuyi Tolupe
Detroit Receiving Hospital, Department of Emergency Medicine, Detroit, Michigan.
Clin Pract Cases Emerg Med. 2021 Nov;5(4):425-428. doi: 10.5811/cpcem.2021.6.52898.
Extracorporeal membrane oxygenation (ECMO) has been well described as a viable option for patients in need of temporary supplemental oxygenation when ventilator capabilities have failed to augment a patient's condition. Less described is the potential use of ECMO for lung protection in the setting of gigantic bullae despite initially adequate oxygenation.
We describe how the early incorporation of ECMO in a patient with coronavirus disease 2019 and necrotizing pneumonia complicated by multiple large and gigantic bullae led to a favorable outcome.
The decision to start ECMO early, despite room for ventilator oxygenation adjustments, may have helped to prevent potential, significant complications such as tension pneumothorax while on positive pressure, thus potentially optimizing the outcome in this patient.
体外膜肺氧合（ECMO）已被充分描述为当呼吸机功能无法改善患者病情时，为需要临时补充氧合的患者提供的一种可行选择。对于巨大肺大疱患者，尽管初始氧合充足，但ECMO在肺保护方面的潜在应用描述较少。
我们描述了一名2019冠状病毒病合并坏死性肺炎并伴有多个大的和巨大肺大疱的患者，早期应用ECMO如何带来了良好的结果。
尽管有调整呼吸机氧合的空间，但早期启动ECMO的决定可能有助于预防正压通气时潜在的严重并发症，如张力性气胸，从而可能优化该患者的治疗结果。
