吸入一氧化氮疗法治疗机械通气的过度充气细支气管炎患者的严重低氧血症
Inhaled nitric oxide therapy for severe hypoxemia in hyperinflated mechanically ventilated bronchiolitis patient.
作者信息
DonaireGarcia Alvaro, Dachepally Rashmitha, Hanna William, Latifi Samir Q, Agarwal Hemant S
机构信息
Department of Pediatric Critical Care, Cleveland Clinic Children's Hospital, 9500 Euclid Avenue M-14, Cleveland, OH, 44195, USA.
出版信息
Respir Med Case Rep. 2022 Apr 1;37:101643. doi: 10.1016/j.rmcr.2022.101643. eCollection 2022.
Management of hospitalized bronchiolitis patients comprises supportive care including non-invasive and invasive mechanical ventilation. Inhaled nitric oxide (iNO) therapy has been used in bronchiolitis patients to manage pulmonary hypertension, acute respiratory distress syndrome, bronchoconstriction or inflammation. We report the role of iNO in management of severe hypoxemia in a 7-month-old mechanically ventilated bronchiolitis patient on 100% oxygen and high ventilator settings who had hyperinflation on chest x-ray, and diffuse bronchospasm on clinical assessment. We believe iNO improved hypoxemia in our patient by optimizing the ventilation/perfusion mismatch, decreasing dead space ventilation and relieving elevated pulmonary vascular resistance associated with alveolar overdistention. Inhaled nitric oxide therapy for severe hypoxemia in hyperinflated mechanically ventilated bronchiolitis patient.
住院毛细支气管炎患者的管理包括支持性治疗，其中有无创和有创机械通气。吸入一氧化氮（iNO）疗法已用于毛细支气管炎患者，以治疗肺动脉高压、急性呼吸窘迫综合征、支气管收缩或炎症。我们报告了iNO在一名7个月大的机械通气毛细支气管炎患者中的作用，该患者在接受100%氧气和高通气设置治疗时出现严重低氧血症，胸部X光显示有肺过度充气，临床评估有弥漫性支气管痉挛。我们认为iNO通过优化通气/灌注不匹配、减少无效腔通气以及缓解与肺泡过度扩张相关的肺血管阻力升高，改善了我们患者的低氧血症。对机械通气的肺过度充气毛细支气管炎患者的严重低氧血症进行吸入一氧化氮治疗。
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