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COVID-19 相关肾病综合征复发患者应用体外膜肺氧合成功治疗危重型急性呼吸窘迫综合征

Successful Management of Critical Acute Respiratory Distress Syndrome following COVID-19 through Extracorporeal Membrane Oxygenation in a Patient with Concurrent Nephrotic Syndrome Relapse.

机构信息

Department of Nephrology, Juntendo University Nerima Hospital, Japan.

Department of Nephrology, Juntendo University Faculty of Medicine, Japan.

出版信息

Intern Med. 2023 Nov 1;62(21):3209-3214. doi: 10.2169/internalmedicine.2293-23. Epub 2023 Aug 9.

Abstract

A 44-year-old man with coronavirus disease 2019 (COVID-19) and nephrotic syndrome relapse was admitted to our intensive-care unit for respiratory failure. Despite receiving mechanical ventilation and immunomodulators, the patient experienced refractory hypoxemia, necessitating venovenous extracorporeal membrane oxygenation (VV-ECMO) therapy. Due to a worsening renal function, continuous hemodiafiltration was initiated. After 11 days, his respiratory status gradually improved, and VV-ECMO was withdrawn. The kidney function and proteinuria improved, and hemodialysis was subsequently discontinued. The patient was discharged 64 days after admission. This case highlights the potential benefit of early ECMO application in dramatically promoting recovery in severe COVID-19 cases.

摘要

一名 44 岁男性患有 2019 年冠状病毒病(COVID-19)和肾病综合征复发,因呼吸衰竭被收入我们的重症监护病房。尽管接受了机械通气和免疫调节剂治疗,但该患者仍出现难治性低氧血症,需要静脉-静脉体外膜肺氧合(VV-ECMO)治疗。由于肾功能恶化,开始进行连续性血液透析滤过。11 天后,他的呼吸状况逐渐改善,VV-ECMO 被撤下。肾功能和蛋白尿改善,随后停止了血液透析。该患者在入院后 64 天出院。本病例强调了早期 ECMO 应用在显著促进严重 COVID-19 病例康复方面的潜在益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d67a/10686741/d46fe2e6aee9/1349-7235-62-3209-g001.jpg

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