본문 바로가기
KERD
논문KCI 등재

Successful Rescue Therapy with Pumpless Extracorporeal Carbon Dioxide Removal in a Patient with Persistent Air Leakage Due to Empyema

0

조회

0

다운로드

0

인용

0

참고문헌

키워드

초록

A young metastatic lung cancer patient developed empyema due to an infection with carbapenem-resistant Acinetobacter baumannii. Hydropneumothorax was detected and managed by a tube thoracotomy. However, persistent air leakage through the chest tube was observed due to the presence of a bronchopleural fistula (BPF). As hypercapnic respiratory failure had progressed and the large air leak did not diminish by conservative management, a pumpless extracorporeal lung assist (pECLA) device was inserted. The pECLA allowed the patient to be weaned from mechanical ventilation and the BPF to heal. The present case shows the effective application of pECLA in a patient with empyema complicated with BPF and severe hypercapnic respiratory failure. pECLA enabled us to minimize airway pressure to aid in the closure of the BPF in the mechanically ventilated patient.

Abstract

A young metastatic lung cancer patient developed empyema due to an infection with carbapenem-resistant Acinetobacter baumannii. Hydropneumothorax was detected and managed by a tube thoracotomy. However, persistent air leakage through the chest tube was observed due to the presence of a bronchopleural fistula (BPF). As hypercapnic respiratory failure had progressed and the large air leak did not diminish by conservative management, a pumpless extracorporeal lung assist (pECLA) device was inserted. The pECLA allowed the patient to be weaned from mechanical ventilation and the BPF to heal. The present case shows the effective application of pECLA in a patient with empyema complicated with BPF and severe hypercapnic respiratory failure. pECLA enabled us to minimize airway pressure to aid in the closure of the BPF in the mechanically ventilated patient.

참고문헌 (10)

  1. Lois M, "Bronchopleural fistulas: an overview of the problem with special focus on endoscopic management", Chest, 128, pp.3955~3965 (2005)
  2. Pierson DJ, "Persistent bronchopleural air leak during mechanical ventilation: a review of 39 cases", Chest, 90, pp.321~323 (1986)
  3. Bein T, "A new pumpless extracorporeal interventional lung assist in critical hypoxemia", hypercapnia, 2006, pp.34, 1372~1377
  4. Flörchinger B, "Pumpless extracorporeal lung assist: a 10-year institutional experience", Ann Thorac Surg, 86, pp.410~417 (2008)
  5. Jung C, "Pumpless extracorporeal lung assist for the treatment of severe, refractory status asthmaticus", J Asthma, 48, pp.111~113 (2011)
  6. Petzoldt M, "Rescue therapy with a pumpless extracorporeal lung assist device in a patient with acute interstitial lung disease and severe refractory hypercapnia", Respir Care, 57, pp.293~297 (2012)
  7. Fischer S, "Interventional lung assist: a new concept of protective ventilation in bridge to lung transplantation", ASAIO J, 54, pp.3~10 (2008)
  8. Pesenti A, "Percutaneous extracorporeal CO2 removal in a patient with bullous emphysema with recurrent bilateral pneumothoraces and respiratory failure", Anesthesiology, 72, pp.571~573 (1990)
  9. Hommel M, "Bronchial fistulae in ARDS patients: management with an extracorporeal lung assist device", Eur Respir J, 32, pp.1652~1655 (2008)
  10. Bombino M, "Bronchopleural fistulae and pulmonary ossification in posttraumatic acute respiratory distress syndrome: successful treatment with extracorporeal support", ASAIO J, 57, pp.336~340 (2011)

관련 논문AI추천

중증 호흡 부전이 발생한 결핵 파괴 폐에서 적용한 Pumpless Extracorporeal Interventional Lung Assist고윤석, 박소희, 박재석, 심태선, 임채만, 하상욱, 홍상범대한중환자의학회 · Acute and Critical Care2013 · 제28권 제3호Pumpless Extracorporeal Interventional Lung Assist를 시행한 중증 호흡부전 1예 -증례 보고-김유정, 서지연, 이재호, 이춘택, 조영재대한중환자의학회 · Acute and Critical Care2012 · 제27권 제2호Extracorporeal Membrane Oxygenation as a Rescue Therapy in a Patient with Non-Iatrogenic Massive Hemoptysis김수완, 김이현, 이종후대한중환자의학회 · Acute and Critical Care2013 · 제28권 제3호Extracorporeal Membrane Oxygenation Therapy for Aspiration Pneumonia in a Patient following Left Pneumonectomy for Lung Cancer유양기, 조장완대한중환자의학회 · Acute and Critical Care2016 · 제31권 제2호침습적 기계환기로도 호전이 되지 않는 치료불응성 천식 환자에서 Interventional Lung Assist를 적용한 1예 -증례 보고-고윤석, 문재영, 오연목, 이영석, 임채만, 주혜진, 허진원, 홍상범대한중환자의학회 · Acute and Critical Care2012 · 제27권 제2호급성 호흡부전 환자에서 Pumpless Extracorporeal Interventional Lung Assist의 생리학적 효과 및 안전성고윤석, 이광하, 임채만, 조우현, 허진원, 홍상범대한중환자의학회 · Acute and Critical Care2010 · 제25권 제4호

이 간행물의 다른 논문 (10건)