Abstract

TOMICIC, Vinko; CATALIOTI, Frank  and  MENDOZA, Sheyla. Extracorporeal CO₂ Removal in a Patient with Status Asthmaticus who Evolved with Barotrauma. Rev. am. med. respir. [online]. 2022, vol.22, n.4, pp.400-405. ISSN 1852-236X.  http://dx.doi.org/ramr.10.56538/ghks7463.

A 20-year-old male with known asthma diagnosis arrived at the Emergency Depart ment of a hospital in his town with history of dyspnea 1 day before admission. The pa tient then became tachycardic, tachypneic and cyanotic and received emergency intu bation. At the ICU (Intensive care Unit) of the tertiary care general hospital, he showed severe bronchospasm, high airway pressure during mechanical ventilation (MV) and severe hypoperfusion. He received crystalloids and norepinephrine for resuscitation. On the third day, he developed subcutaneous emphysema, pneumothorax and hyper capnia with mixed acidosis. We decided to use ultra-protective mechanical ventila tion concomitant with Novalung®. With this strategy, we were able to reduce airway pressures, iPEEP (intrinsic positive end-expiratory pressure) and resistive mechanical power (MP) and improve hypercapnia and acidosis. The patient was connected to Novalung® for ten days and showed good evolution. Finally, he was extubated and discharged from the ICU, and left the hospital in good condition.

Keywords : Status asthmaticus; Ventilator-induced lung injury; Extracorporeal circulation; Barotrauma.

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