[Extracorporeal CO 2 removal as life support system for a severe organizing pneumonia].

Autor: Rival G; Service de réanimation polyvalente, centre hospitalier de Montélimar, quartier Beausseret, BP 249, 26200 Montélimar, France; Service de pneumologie, centre hospitalier de Montélimar, quartier Beausseret, BP 249, 26200 Montélimar, France. Electronic address: gilles.rival@yahoo.fr., Millet O; Service de réanimation polyvalente, centre hospitalier de Montélimar, quartier Beausseret, BP 249, 26200 Montélimar, France., Capellier G; Service de réanimation médicale adulte, pôle urgences-SAMU-réanimation, centre hospitalier régional universitaire, 4, boulevard Fleming, 25000 Besançon, France.
Jazyk: francouzština
Zdroj: Revue de pneumologie clinique [Rev Pneumol Clin] 2016 Dec; Vol. 72 (6), pp. 373-376. Date of Electronic Publication: 2016 Nov 09.
DOI: 10.1016/j.pneumo.2016.09.006
Abstrakt: Introduction: Acute lung injuries are usually found in intensive care unit. The diffuse alveolar damage (DAD) is the associated histological pattern and the most severe end-stage of the disease. Organizing pneumonia (OP), for which corticosteroids are the reference therapy, can mimic DAD. While postponing the response to treatment, to limit mechanical ventilation side effects, extracorporeal membrane oxygene can be proposed. We present a case of a severe OP for which extracorporeal CO 2 removal (ECCO 2 R) is used as a bridge to recovery under corticosteroid therapy.
Case Report: In the context of a flu-like syndrome, the non-recovery of a lung impairment is reported to a severe OP. ECCO 2 R is applied when using an ultraprotective ventilation and while waiting for lung healing under corticosteroid. This strategy allowed successful recovery, early physical therapy and active mobilization.
Conclusion: This observation presents the diagnostic and therapeutic difficulties of the lung parenchymental disease in intensive care. OP must be recognized. ECCO 2 R can be used in severe OP as a bridge to recovery while waiting for the corticosteroid efficacy.
(Copyright © 2016 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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