Near-fatal pediatric asthma managed with pumpless arteriovenous carbon dioxide removal*

Conrad, Steven A.; Green, Rebecca; Scott, L. Keith

doi:10.1097/01.ccm.0000288104.97602.b3

Cited by 23 publications

(12 citation statements)

References 15 publications

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“…Volume of blood in this circuit is approximately 290 cc, of which nearly 270 cc lies in the oxygenator. [34]…”

Section: Discussionmentioning

confidence: 99%

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Pumpless arteriovenous carbon dioxide removal: A novel simplified strategy for severe asthma in children

Aravantagi¹,

Patra²,

Shekar³

et al. 2011

Indian Journal of Critical Care Medicine

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Status asthmaticus unresponsive to pharmacotherapy is conventionally managed with mechanical ventilation, which has its inherent challenges due to barotrauma, dynamic hyperinflation and autopositive end-expiratory pressure (auto-PEEP). Extracorporeal membrane oxygenation has been used as a last resort in respiratory failure due to refractory asthma; however, it entails many complications. In contrast, arteriovenous carbon dioxide removal (AVCO2R) is a novel strategy that has been shown to be highly effective in adults with acute respiratory failure. Only one pediatric case series of pediatric asthma managed with AVCO2R have been published so far. We herein report a case of severe asthma in a 9-year-old boy who developed severe hypercapnia (Pco2 97 mmHg) and acidosis (pH 7.09) despite being on mechanical ventilation. Within 4 h of initiation of AVCO2R, PCo2 drastically reduced to near-normal levels. He was discharged on day 9 of hospital stay without any complications.

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“…Volume of blood in this circuit is approximately 290 cc, of which nearly 270 cc lies in the oxygenator. [34]…”

Section: Discussionmentioning

confidence: 99%

“…[3] Only one case series of pediatric asthma managed with AVCO 2 R have been reported. [4] We report a case of life-threatening asthma that developed severe hypercapnia and acidosis on mechanical ventilation and was successfully managed with AVCO 2 R.…”

Section: Introductionmentioning

confidence: 99%

Pumpless arteriovenous carbon dioxide removal: A novel simplified strategy for severe asthma in children

Aravantagi¹,

Patra²,

Shekar³

et al. 2011

Indian Journal of Critical Care Medicine

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“…In contrast, ECLS has been used in severely injured patients with refractory hypoxemia [11–13]. Similarly, ECLS has been used for patients with tracheobronchial injuries [14] and for severe acute asthma [8, 15]. …”

Section: Discussionmentioning

confidence: 99%

Successful Use of Extracorporeal Life Support after Double Traumatic Tracheobronchial Injury in a Patient with Severe Acute Asthma

Valette¹,

Desjouis²,

Massetti³

et al. 2011

Pulmonary Medicine

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We report the case of an asthmatic patient with blunt trachea and left main bronchus injuries who developed acute severe asthma after surgical repair. Despite medical treatment and ventilatory support, asthma persisted with high airway pressures and severe respiratory acidosis. We proposed venovenous extracorporeal life support for CO2 removal which allowed arterial blood gas normalization and airway pressures decrease. Extracorporeal life support was removed on day five after medical treatment of acute severe asthma. So we report the successful use of extracorporeal life support for operated double blunt tracheobronchial injury with acute severe asthma.

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“…Pediatric patients in status asthmaticus placed on ECMO have had a reversal of hypercapnia and acidosis in as little as 2-4 h of treatment (29,30). At present, there are no evidence-based guidelines on when to initiate ECMO for status asthmaticus, but a study by Kukita et al has suggested use in the setting of persistent hypoxemia, pH < 7.2, PCO 2 > 100 mm Hg, or in the face of life-threatening complications due to ventilation, such as hypotension or barotrauma (31).…”

Section: Indicationsmentioning

confidence: 99%

Pediatric Extracorporeal Membrane Oxygenation: An Introduction for Emergency Medicine Physicians

Gehrmann¹,

Hafner

Montgomery

et al. 2015

The Journal of Emergency Medicine

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Near-fatal pediatric asthma managed with pumpless arteriovenous carbon dioxide removal*

Cited by 23 publications

References 15 publications

Pumpless arteriovenous carbon dioxide removal: A novel simplified strategy for severe asthma in children

Pumpless arteriovenous carbon dioxide removal: A novel simplified strategy for severe asthma in children

Successful Use of Extracorporeal Life Support after Double Traumatic Tracheobronchial Injury in a Patient with Severe Acute Asthma

Pediatric Extracorporeal Membrane Oxygenation: An Introduction for Emergency Medicine Physicians

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