Adjunctive extracorporeal carbon dioxide removal in refractory status asthmaticus.

Publisher: BMJ Pub. Group Country of Publication: England NLM ID: 101526291 Publication Model: Electronic Cited Medium: Internet ISSN: 1757-790X (Electronic) Linking ISSN: 1757790X NLM ISO Abbreviation: BMJ Case Rep Subsets: MEDLINE

Original Publication: London : BMJ Pub. Group

Critical Care* ; Extracorporeal Membrane Oxygenation*; Carbon Dioxide/*metabolism ; Hypercapnia/*therapy ; Respiratory Insufficiency/*therapy ; Status Asthmaticus/*therapy; Adult ; Chest Tubes ; Extracorporeal Circulation ; Humans ; Hypercapnia/physiopathology ; Male ; Respiratory Insufficiency/metabolism ; Status Asthmaticus/metabolism ; Status Asthmaticus/physiopathology ; Treatment Outcome

Status asthmaticus (SA) is a life-threatening disorder. Severe respiratory failure may require extracorporeal membrane oxygenation (ECMO). Previous reports have demonstrated utility of ECMO in SA in various patients with varying success. A 25-year-old man was admitted with status asthmatics and severe hypercapnic respiratory failure. Despite tailored ventilator therapies, such as pressure control ventilation and maximal pharmacological therapy, including general anaesthesia, the patient’s condition deteriorated rapidly. Veno-venous ECMO (VV-ECMO) was provided for respiratory support. The patient’s clinical condition improved over the following 72 hours and was discharged from the intensive care unit on day 3. This case report demonstrates the successful use of VV-ECMO in a patient with severe respiratory failure due to SA, who failed to respond to maximal therapy. This case adds support to a growing body of literature that shows that ECMO can be used with success for refractory status asthmaticus.
Competing Interests: Competing interests: None declared.
(© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

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Keywords: intensive care; respiratory medicine

142M471B3J (Carbon Dioxide)

Date Created: 20170730 Date Completed: 20180430 Latest Revision: 20231112

20231112

PMC5623218

10.1136/bcr-2017-220693

28754757