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Korean J Crit Care Med > Volume 28(3); 2013 > Article
Korean Journal of Critical Care Medicine 2013;28(3): 192-196. doi: https://doi.org/10.4266/kjccm.2013.28.3.192
중증 호흡 부전이 발생한 결핵 파괴 폐에서 적용한 Pumpless Extracorporeal Interventional Lung Assist
박소희ㆍ하상욱*ㆍ박재석†ㆍ홍상범ㆍ심태선ㆍ임채만ㆍ고윤석
울산대학교 의과대학 서울아산병원 중환자의학 및 호흡기내과학교실, *응급의학교실, †계명대학교 의과대학 중환자의학 및 호흡기내과학교실
A Case of Pumpless Interventional Lung Assist Application in a Tuberculosis Destroyed Lung Patient with Severe Hypercapnic Respiratory Failure
So Hee Park, Sang Ook Ha, Jae Seok Park, Sang Bum Hong, Tae Sun Shim, Chae Man Lim, Younsuck Koh
1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea. yskoh@amc.seoul.kr
2Department of Emergency Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
3Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
ABSTRACT
Pumpless extracorporeal interventional lung assist (iLA) is a rescue therapy allowing effective carbon dioxide removals and lung protective ventilator settings. Herein, we report the use of a pumpless extracorporeal iLA in a tuberculosis destroyed lung (TDL) patient with severe hypercapnic respiratory failures. A 35-year-old male patient with TDL was intubated due to CO2 retention and altered mentality. After 11 days, Ventilator Associated Pneumonia (VAP) had developed. Despite the maximal mechanical ventilator support, his severe respiratory acidosis was not corrected. We applied the iLA for the management of refractory hypercapnia with respiratory acidosis. This case suggests that the iLA is an effective rescue therapy for TDL patients with ventilator refractory hypercapnia.
Key Words: pumpless extracorporeal lung assist; respiratory failure; tuberculosis destroyed lung
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