Successful Rescue Therapy with Pumpless Extracorporeal Carbon Dioxide Removal in a Patient with Persistent Air Leakage Due to Empyema.
10.4266/kjccm.2016.00185
- Author:
Jaeyoung CHO
;
Yeon Joo LEE
;
Jae Ho LEE
;
Choon Taek LEE
;
Young Jae CHO
- Publication Type:Case Report
- Keywords:
bronchial fistula;
empyema;
hydropneumothorax;
hypercapnia;
pumpless extracorporeal lung assist;
respiratory insufficiency
- MeSH:
Acinetobacter baumannii;
Bronchial Fistula;
Carbon Dioxide*;
Carbon*;
Chest Tubes;
Empyema*;
Fistula;
Humans;
Hydropneumothorax;
Hypercapnia;
Lung;
Lung Neoplasms;
Respiration, Artificial;
Respiratory Insufficiency;
Thoracotomy
- From:Korean Journal of Critical Care Medicine
2017;32(3):284-290
- CountryRepublic of Korea
- Language:English
-
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.
