Decapneization as supportive therapy for the treatment of status asthmaticus: a case report
| Autor: | Fabrizio Gritti, Irene Esposito, Francesco Imperatore, Giovanni Liguori, Rossella Esposito, Maria De Cristofaro, Chiara Cafora, Paolo Francesco Marsilia |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_treatment
Status Asthmaticus Case Report 030204 cardiovascular system & hematology Air trapping Protective mechanical ventilation Hypoxemia Hypercapnia 03 medical and health sciences 0302 clinical medicine medicine Tidal Volume Humans Dynamic hyperinflation Mechanical ventilation Respiratory distress business.industry General Medicine Carbon Dioxide medicine.disease Respiration Artificial Asthma 030220 oncology & carcinogenesis Acute severe asthma Anesthesia Breathing Decapneization Medicine medicine.symptom business |
| Zdroj: | Journal of Medical Case Reports Journal of Medical Case Reports, Vol 15, Iss 1, Pp 1-4 (2021) |
| ISSN: | 1752-1947 |
| Popis: | Background Acute severe asthma is a life-threatening medical emergency. Characteristics of asthma include increased airway resistance and dynamic pulmonary hyperinflation that can manifest in dangerous levels of hypercapnia and acidosis, with significant mortality and morbidity. Severe respiratory distress can lead to endotracheal intubation followed by mechanical ventilation, which can cause increased air trapping with dynamic hyperinflation, predisposing the lungs to barotraumas. Case presentation The present case report describes the use of the minimally invasive ECCO2R ProLUNG® (Estor) with protective low-tidal-volume ventilation, in a Caucasian patient with near-fatal asthma and with no response to conventional therapy. Conclusions Since hypercarbia rather than hypoxemia is the primary abnormality in status asthmaticus, a rescue therapeutic strategy combining the ECCO2R membrane ProLUNG® (Estor) with ultra-protective low-tidal-volume ventilation can be successfully applied to limit the risk of severe barotrauma during invasive mechanical ventilation. ECCO2R ProLUNG® is a partial respiratory support technique that, based on the use of an extracorporeal circuit with a gas-exchange membrane, achieves relevant CO2 clearance directly from the blood using double-lumen venous-venous vascular access, at blood flow in the range of 0.4–1.0 L/minute. |
| Databáze: | OpenAIRE |
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