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Combined use of hypothermia and buffering in the treatment of critical respiratory failure
Author(s) -
Wetterberg T.,
Steen S.
Publication year - 1992
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1992.tb03504.x
Subject(s) - medicine , hypothermia , intensive care medicine , respiratory failure , respiratory system , anesthesia
A 20‐year‐old male, recovering from post‐traumatic ARDS, subsequently developed pneumonia with extreme hypercapnia (Paco 2 max 19.4 kPa) and hypoxemia (Pao 2 min 5.1 kPa), in spite of maximal mechanical ventilation. Hypothermia was induced by surface cooling, reducing the body temperature from 40°C to a mean of 33.3°C. Buffer infusion (1375 mmol) during the first 2 days increased base excess from 3 to 22 mmol/l and pH from 7.16 to a median value of 7.30. Active cooling was discontinued on day 11. Weaning from the ventilator was possible 9 days later and the patient subsequently recovered fully. Combined use of hypothermia and buffering might offer an alternative to extracorporeal lung assist (ECLA) and facilitate a reduction of barotrauma and oxygen toxicity during mechanical ventilation.