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- W1198227279 abstract "Interventional lung assist devices (iLA) are pumpless, arterio-venous, extra-corporeal lung support devices with a low resistance gas exchange membrane that allows rapid removal of carbon dioxide (CO2) and moderate oxygenation. Currently they are mainly used in acute respiratory distress syndrome and as a bridge to lung transplantation. We successfully used iLA in an near fatal asthmatic patient with hypercapnic respiratory failure refractory to conventional ventilation. A male patient aged 55 years presented with a near fatal exacerbation of asthma. He was a current smoker with co-morbidities including obesity, previous poliomyelitis affecting right leg, stroke and ischaemic heart disease. Despite full medical treatment, endobronchial intubation and invasive mechanical ventilation (IMV) plus a range of intravenous and inhaled medications including intravenous terbutaline, ketamine, adrenaline and inhaled adrenaline and isofluorane he developed persistent hypercapnic respiratory failure with PaCO2 > 20. Conventional ventilation strategies were ineffective with poor compliance, high peak airway pressures and prolonged inspiratory times resulting in air trapping and hyperinflation. Therefore an iLA was inserted on day 2. This resulted in enhanced CO2 removal (Pa CO2 21 down to PaCO2 7.6) and allowed protective lung ventilation at lower pressures with less gas trapping and hyperinflation. The iLA was removed on day 12 with spontaneous breathing on day 19. This could represent a useful future strategy for persistent hypercapnic respiratory failure unresponsive to conventional measures in obstructive diseases such as asthma and COPD." @default.
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- W1198227279 date "2011-09-01" @default.
- W1198227279 modified "2023-09-27" @default.
- W1198227279 title "Successful use of interventional lung assist device in a patient with near fatal asthma" @default.
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