Noninvasive ventilation and low-flow veno-venous extracorporeal carbon dioxide removal as a bridge to lung transplantation in a child with refractory hypercapnic respiratory failure due to bronchiolitis obliterans

Andrea Moscatelli, Giancarlo Ottonello, Laura Nahum, Elisabetta Lampugnani, Franco Puncuh, Alessandro Simonini, Miriam Tumolo, Pietro Tuo

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To report the successful management of end-stage hypercapnic respiratory failure through the association of noninvasive mechanical ventilation and a novel automated device (Decapsmart) of low-flow veno-venous extracorporeal CO2 removal. Design: Case report. Settings: Pediatric intensive care unit at a tertiary care children's hospital. Patient: A pediatric patient affected by bronchiolitis obliterans with refractory hypercapnic respiratory failure. The patient received successful lung transplantation after respiratory support with noninvasive mechanical ventilation and a novel automated device of low-flow veno-venous extracorporeal CO2 removal. Interventions: Treatment of end-stage hypercapnic respiratory failure with the association of noninvasive ventilation and lowflow veno-venous extracorporeal CO2 removal as a bridge to lung transplantation. Measurements and Main Results: Respiratory support controlling hypercapnia, limiting volutrauma, barotraumas, and preventing the incidence of ventilator-associated pneumonia/lung colonization. Conclusion: Noninvasive mechanical ventilation and Decapsmart have proven efficacious in managing refractory hypercapnic respiratory failure in a pediatric patient awaiting lung transplantation.

Original languageEnglish
JournalPediatric Critical Care Medicine
Volume11
Issue number1
DOIs
Publication statusPublished - 2010

Keywords

  • Bridge
  • Bronchiolitis obliterans
  • Hypercapnic respiratory failure
  • Low-flow veno-venous extracorporeal CO removal
  • Lung transplantation
  • Noninvasive mechanical ventilation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Critical Care and Intensive Care Medicine

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