| Long-term extracorporeal membrane oxygenation with minimal ventilatory support: a new paradigm for severe ARDS? | |
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MedLine Citation:
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PMID: 21617600 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Pulmonary tuberculosis can lead to acute respiratory distress syndrome (ARDS) which is associated with high mortality. We report the case of a patient with pulmonary tuberculosis and severe ARDS (PaO2/FiO2<100 mmHg) who was initially managed with advanced up-to-date treatments (protective ventilation and extracorporeal membrane oxygenation, ECMO) but failed to improve. After a month of failure and the development of bilateral pneumothoraces, we drastically changed our therapeutic strategy: we maximized ECMO support to maintain oxygenation, we greatly reduced ventilation pressures and we left the pneumothoraces undrained. From then on, the patient improved and he eventually survived. This case suggests that ECMO permits large reductions in lung inflation and ventilation to rest the lungs, while maintaining acceptable oxygenation. The combination of ECMO and markedly attenuated ventilation strategy may be effective in cases of severe ARDS. |
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Authors:
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T Mauri; G Foti; A Zanella; M Bombino; A Confalonieri; N Patroniti; G Bellani; A Pesenti |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-5-26 |
Journal Detail:
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Title: Minerva anestesiologica Volume: - ISSN: 1827-1596 ISO Abbreviation: - Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-5-27 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0375272 Medline TA: Minerva Anestesiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Experimental Medicine, Milan-Bicocca University, Monza, Italy - antonio.pesenti@unimib.it. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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