Open AccessPumpless arteriovenous carbon dioxide removal: A novel simplified strategy for severe asthma in children
Author(s) -
Avinash Aravantagi,
Kamakshya P. Patra,
Saketh Palasamudram Shekar,
L. Keith Scott
Publication year - 2011
Publication title -
indian journal of critical care medicine/indian journal of critical care medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.317
H-Index - 30
eISSN - 1998-359X
pISSN - 0972-5229
DOI - 10.4103/0972-5229.92078
Subject(s) - medicine , hypercapnia , respiratory acidosis , mechanical ventilation , asthma , extracorporeal membrane oxygenation , anesthesia , refractory (planetary science) , respiratory failure , ventilation (architecture) , acute severe asthma , respiratory system , intensive care medicine , acidosis , lung , respiratory disease , mechanical engineering , physics , astrobiology , engineering
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 (AVCO(2)R) 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 AVCO(2)R 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 AVCO(2)R, PCo(2) drastically reduced to near-normal levels. He was discharged on day 9 of hospital stay without any complications.