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Novel treatment (new drug/intervention; established drug/procedure in new situation)
CASE REPORT
Adjunctive extracorporeal carbon dioxide removal in refractory status asthmaticus
  1. Chuan Jiang1,
  2. Jodi Galaydick2,
  3. Harold Fernandez3,
  4. Jonathan Caronia4
  1. 1Department of Medicine, Northwell Health, Manhasset, New York, USA
  2. 2Department of Critical Care Medicine, Northwell Health, Bayshore, USA
  3. 3Department of Cardiothoracic Surgery, Northwell Health, Bay Shore, New York, USA
  4. 4Department of Telehealth, Northwell Health, Syosset, New York, USA
  1. Correspondence to Dr Chuan Jiang, cjiang{at}northwell.edu

Summary

Status asthmaticus (SA) is a life-threatening disorder. Severe respiratory failure may require extracorporeal membrane oxygenation (ECMO). Previous reports have demonstrated utility of ECMO in SA in various patients with varying success. A 25-year-old man was admitted with status asthmatics and severe hypercapnic respiratory failure. Despite tailored ventilator therapies, such as pressure control ventilation and maximal pharmacological therapy, including general anaesthesia, the patient’s condition deteriorated rapidly. Veno-venous ECMO (VV-ECMO) was provided for respiratory support. The patient’s clinical condition improved over the following 72 hours and was discharged from the intensive care unit on day 3. This case report demonstrates the successful use of VV-ECMO in a patient with severe respiratory failure due to SA, who failed to respond to maximal therapy. This case adds support to a growing body of literature that shows that ECMO can be used with success for refractory status asthmaticus.

  • intensive care
  • respiratory medicine

https://doi.org/10.1136/bcr-2017-220693

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    Footnotes

    • Contributors CJ was responsible for creation of the first draft of this manuscript, analysis and interpretation of the data and literature review. JG was responsible for analysis and interpretation of the data and performing manuscript revisions. HF was responsible for acquisition of data and performing manuscript revisions. JC conceived of this case report and was in charge of final approval.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.