| Autor: |
Jumpei Kohara, Shinichi Kai, Kazuya Hashimoto, Yudai Takatani, Naoya Tanabe, Satoshi Hamada, Kosai Cho, Tomoharu Tanaka, Isao Ito, Shigeru Ohtsuru |
| Jazyk: |
angličtina |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
JA Clinical Reports, Vol 8, Iss 1, Pp 1-5 (2022) |
| Druh dokumentu: |
article |
| ISSN: |
2363-9024 |
| DOI: |
10.1186/s40981-022-00505-8 |
| Popis: |
Abstract Background Ventilatory management of respiratory failure with pneumomediastinum/subcutaneous emphysema is not established. Herein, we report a case of severe COVID-19 pneumonia with extensive pneumomediastinum/subcutaneous emphysema, rescued by thorough lung-protective ventilatory management after applying the VV-ECMO. Case presentation A 68-year-old male with no medical history was admitted to a local hospital and diagnosed with COVID-19 pneumonia. His pulmonary parameters worsened during invasive ventilation due to the development of pneumomediastinum/subcutaneous emphysema, and then he was transferred to our hospital. On arrival, we immediately decided to apply VV-ECMO and switch to ultraprotective ventilation. After maintaining the initial ventilation with a neuromuscular blocking agent for 2 days, we gradually increased PEEP while limiting PIP to 25 cmH2O. The patient was weaned off VV-ECMO on day 10; he was transferred to the medical ward after extubation. Conclusions Lung-protective ventilatory management should be performed thoroughly during VV-ECMO in severe COVID-19 pneumonia with pneumomediastinum/subcutaneous emphysema. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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