H. Nakajima, T. Kutsuwada, T. Ohdaira, A. Saito, K. Satoh, K. Igarashi, E. Suzuki, M. Arakawa
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引用次数: 3
摘要
我们报告一例严重军团菌肺炎急性呼吸衰竭,成功地管理与静脉-静脉体外膜氧合(VV-ECMO)。患者有发热和咳嗽4天的病史。他情况危急,呼吸衰竭加剧。开始机械通气、容积置换和抗生素治疗。尽管增加了机械通气支持(FiO2 100%, TV 10 ml/kg, f30 /min, PEEP 5 cmH20),但PaO2仍低于40Torr,并采取了生命维持措施。开始VV-ECMO(流量30ml /kg/min),患者反应良好,PaO2升高。红霉素治疗肺炎有效。VV-ECMO维持92小时,11天后成功停止机械通气,停止呼吸机支持82天后出院。血清抗体检查证实军团菌感染。VV-ECMO可能在细菌性肺炎引起的急性呼吸衰竭患者的治疗中发挥作用。
[Extracorporeal membrane oxygenation for acute respiratory failure induced by Legionella pneumoniae. (Case report)].
We report a case of severe legionella pneumonia with acute respiratory failure, successfully managed with veno-venous extracorporeal membrane oxygenation (VV-ECMO). The patient presented with 4-day history of fever and cough. He was in critical condition, with exacerbated respiratory failure. Mechanical ventilation, volume replacement and antibiotic therapy were initiated. Despite increasing mechanical ventilatory support (FiO2 100%, TV 10 ml/kg, f 30/min, PEEP 5 cmH20), PaO2 fell below 40Torr and life sustaining measures were undertaken. VV-ECMO (flow 30 ml/kg/min) was commenced, and the patient responded well, with an elevation of PaO2. Erythromycin therapy was effective against the pneumonia. VV-ECMO was maintained for 92 hours, mechanical ventilation was successfully discontinued 11 days after and the patient was discharged 82 days after cessation of ventilator support. Serum antibody examination proved legionella infection. VV-ECMO may have a role in the management of patients with acute respiratory failure caused by bacterial pneumonia.