ECCO2R案例研究

IF 0.3 Q4 CRITICAL CARE MEDICINE
Marlice van Dyk
{"title":"ECCO2R案例研究","authors":"Marlice van Dyk","doi":"10.1016/j.ejccm.2018.12.016","DOIUrl":null,"url":null,"abstract":"<div><p>Hypercapnic respiratory failure is common in ICU due to ARDS and COPD exacerbations. The use of ECCO2R has changed the way we manage these patients. We report a patient with COPD exacerbation that failed NIV and placed on low flow ECCO2R. Low flow ECCO2R does not support oxygenation and only clears a proportion of the CO2 produced.</p><p>Presentation of the case: a 64 y old women with severe COPD who failed NIV was placed on ECCO2R with the Hemolung system. The severe respiratory acidosis cleared and intubation was avoided. After a few days, she became more hypoxic, and the decision was made not to intubate this patient.</p><p>There is increased CO<sub>2</sub> production and decreased clearance of CO<sub>2</sub> during COPD exacerbation. ECCO<sub>2</sub>R has been shown to improve mortality and decrease the need for intubation. There are various ECCO<sub>2</sub>R systems on the market with different flows and differently sized oxygenators.</p><p>The use of ECCO<sub>2</sub>R in selected patients is a promising add-on to conventional management of these patients. The difficulty in predicting the progression of the disease will always be a challenge. Extracorporeal therapies should be performed in centres that are experienced in the management of these patients.</p></div>","PeriodicalId":31233,"journal":{"name":"Egyptian Journal of Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.3000,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejccm.2018.12.016","citationCount":"0","resultStr":"{\"title\":\"ECCO2R case study\",\"authors\":\"Marlice van Dyk\",\"doi\":\"10.1016/j.ejccm.2018.12.016\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>Hypercapnic respiratory failure is common in ICU due to ARDS and COPD exacerbations. The use of ECCO2R has changed the way we manage these patients. We report a patient with COPD exacerbation that failed NIV and placed on low flow ECCO2R. Low flow ECCO2R does not support oxygenation and only clears a proportion of the CO2 produced.</p><p>Presentation of the case: a 64 y old women with severe COPD who failed NIV was placed on ECCO2R with the Hemolung system. The severe respiratory acidosis cleared and intubation was avoided. After a few days, she became more hypoxic, and the decision was made not to intubate this patient.</p><p>There is increased CO<sub>2</sub> production and decreased clearance of CO<sub>2</sub> during COPD exacerbation. ECCO<sub>2</sub>R has been shown to improve mortality and decrease the need for intubation. There are various ECCO<sub>2</sub>R systems on the market with different flows and differently sized oxygenators.</p><p>The use of ECCO<sub>2</sub>R in selected patients is a promising add-on to conventional management of these patients. The difficulty in predicting the progression of the disease will always be a challenge. Extracorporeal therapies should be performed in centres that are experienced in the management of these patients.</p></div>\",\"PeriodicalId\":31233,\"journal\":{\"name\":\"Egyptian Journal of Critical Care Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.3000,\"publicationDate\":\"2018-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.ejccm.2018.12.016\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Egyptian Journal of Critical Care Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2090730318300537\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Egyptian Journal of Critical Care Medicine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2090730318300537","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 0

摘要

高碳酸血症性呼吸衰竭是常见的ICU由于ARDS和COPD加重。ECCO2R的使用改变了我们管理这些患者的方式。我们报告了一位COPD加重患者,NIV失败并放置低流量ECCO2R。低流量ECCO2R不支持氧化,只清除产生的一部分二氧化碳。病例介绍:一名64岁高龄严重慢性阻塞性肺病妇女,NIV失败,被放置在ECCO2R与Hemolung系统。严重呼吸性酸中毒清除,避免插管。几天后,她变得更加缺氧,决定不给病人插管。慢性阻塞性肺病加重期间,CO2产生增加,CO2清除率降低。ECCO2R已被证明可改善死亡率并减少插管需求。市场上有各种各样的ECCO2R系统,具有不同的流量和不同大小的氧合器。在选定的患者中使用ECCO2R是对这些患者进行常规治疗的一种有希望的补充。预测疾病进展的困难始终是一个挑战。体外治疗应在管理这些患者经验丰富的中心进行。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
ECCO2R case study

Hypercapnic respiratory failure is common in ICU due to ARDS and COPD exacerbations. The use of ECCO2R has changed the way we manage these patients. We report a patient with COPD exacerbation that failed NIV and placed on low flow ECCO2R. Low flow ECCO2R does not support oxygenation and only clears a proportion of the CO2 produced.

Presentation of the case: a 64 y old women with severe COPD who failed NIV was placed on ECCO2R with the Hemolung system. The severe respiratory acidosis cleared and intubation was avoided. After a few days, she became more hypoxic, and the decision was made not to intubate this patient.

There is increased CO2 production and decreased clearance of CO2 during COPD exacerbation. ECCO2R has been shown to improve mortality and decrease the need for intubation. There are various ECCO2R systems on the market with different flows and differently sized oxygenators.

The use of ECCO2R in selected patients is a promising add-on to conventional management of these patients. The difficulty in predicting the progression of the disease will always be a challenge. Extracorporeal therapies should be performed in centres that are experienced in the management of these patients.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
5
审稿时长
42 weeks
期刊介绍: The Egyptian Journal of Critical Care Medicine is the official Journal of the Egyptian College of Critical Care Physicians, the most authoritative organization of Egyptian physicians involved in the multi-professional field of critical care medicine. The journal is intended to provide a peer-reviewed source for multidisciplinary coverage of general acute and intensive care medicine and its various subcategories including cardiac, pulmonary, neuro, renal as well as post-operative care. The journal is proud to have an international multi-professional editorial board in the broad field of critical care that will assist in publishing promising research and breakthrough reports that lead to better patients care in life threatening conditions, and bring the reader a quick access to the latest diagnostic and therapeutic approaches in monitoring and management of critically ill patients.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信