Gasche Y, Romand J A, Prêtre R, Suter P M
Division of Surgical Intensive Care, Hôpital Cantonal Universitaire, Geneva, Switzerland.
Eur Respir J. 1994 Apr;7(4):821-3. doi: 10.1183/09031936.94.07040821.
We describe the beneficial effects of an intravenous oxygenator (IVOX) on ventilatory pressure requirement, and also several severe complications related to its use in a young trauma victim developing severe acute respiratory distress syndrome (ARDS). In this patient, adequate systemic oxygenation could not be maintained despite the use of fractional inspired oxygen of 1.0, high level positive end-expiratory pressure (PEEP), and nitric oxide inhalation (30 ppm). The introduction of an intravenous oxygenator improved arterial oxygenation and CO2 elimination, allowing a decrease in minute ventilation and airway pressure. However, hepatic cytolysis, acute renal dysfunction and iliac vein thrombosis developed concomitantly, in spite of full anticoagulation with heparin. These complications resolved rapidly after removal of the IVOX device and the patient made a good recovery.
我们描述了静脉内氧合器（IVOX）对通气压力需求的有益作用，以及在一名发生严重急性呼吸窘迫综合征（ARDS）的年轻创伤患者中使用该设备时出现的几种严重并发症。在该患者中，尽管吸入氧分数为1.0、采用高水平呼气末正压（PEEP）并吸入一氧化氮（30 ppm），仍无法维持足够的全身氧合。静脉内氧合器的使用改善了动脉氧合和二氧化碳清除，使得分钟通气量和气道压力得以降低。然而，尽管使用肝素进行了充分抗凝，仍同时出现了肝细胞溶解、急性肾功能障碍和髂静脉血栓形成。移除IVOX设备后，这些并发症迅速得到缓解，患者恢复良好。
