Exogenous surfactant as a bridge to prolonged “total lung rest” in severely injured patient during extracorporeal membrane oxygenation
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We report a case of a 20-year-old male patient suffering from motorcycle accident complicated by rapid development of severe refractory hypoxemia and hypercapnia due to serious bilateral lung contusions and lacerations. Positive pressure mechanical ventilation induced pressure-dependent massive air leak from disrupted pulmonary tissue. Simultaneous implementation of veno-venous extracorporeal membrane oxygenation together with surfactant application allowed prolonged disconnection of patient from mechanical ventilation (“total lung rest” mode). Despite considerable areas of nonaerated tissue on computed tomography prior to the disconnection from mechanical ventilation, almost total functional recovery of lungs was eventually achieved.
KeywordsAcute respiratory distress syndrome Extracorporeal membrane oxygenation Exogenous surfactant Total lung rest
Support by Ministry of Health of the Czech Republic MH CZ—DRO—FNOs/2013 Grant is acknowledged.
- 5.Serpa Neto A, Schmidt M, Azevedo LC, Bein T, Brochard L, Beutel G, et al. Associations between ventilator settings during extracorporeal membrane oxygenation for oxygenation for refractory hypoxemia and outcome in patiens with acute respiratory distress syndrome: a pooled individual patient data analysis: Mechanical ventilation during ECMO. Intensive Care Med. 2016;42:1672–84.CrossRefPubMedGoogle Scholar
- 6.Gopinath R. Ventilatory strategies in extracorporeal membrane oxygenation. Manual of extracorporeal membrane oxygenation in the ICU. 1st ed. Jaypee Brothers Medical Publishers, New Delhi, 2013: pp. 81–3.Google Scholar