부산대학교 도서관

Background Near-fatal asthma attacks are life threatening events that often require mechanical ventilation. Extracorporeal carbon dioxide removal (ECCO.sub.2R) is, beside extracorporeal membrane oxygenation (ECMO), a well-established rescue option whenever ventilation gets to its limits. But there seems to be very rare experience with those techniques in avoiding mechanical ventilation in severe asthma attacks. Case presentation A 67-year-old man with a near-fatal asthma attack deteriorated under non-invasive ventilation conditions. Beside pharmacological treatment, the intensivists decided to use an extracorporeal carbon dioxide removal system (ECCO.sub.2R) to avoid sedation and intubation. Within only a few hours, there was a breakthrough and the patient's status improved continuously. One and a half days later, weaning from ECCO.sub.2R was already completed. Conclusions The discussion deals with several advantages of extracorporeal lung support in acute asthma, the potential of avoiding intubation and sedation, as well as the benefits of a conscious and spontaneously breathing patient. Extracorporeal membrane oxygenation (ECMO) in general and ECCO.sub.2R in particular is a highly effective method for the treatment of an acute near-fatal asthma attack. Pathophysiological aspects favor the "awake" approach, without sedation, intubation, and mechanical ventilation. Therefore, experienced clinicians might consider "awake" ECCO.sub.2R in similar cases. Keywords: ECCO.sub.2R, Near-fatal asthma, ECMO
Author(s): Thomas-Michael Schneider[sup.1] , Tibor Bence[sup.1] and Franz Brettner[sup.1] Background Extracorporeal CO[sub.2] removal (ECCO[sub.2] R) is an extracorporeal membrane oxygenation (ECMO) subtype that is well established in intensive care medicine. [...]