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Thrombotic Complications during Interventional Lung Assist: Case Series.

Kim EJ, Cho WH, Ahn EY, Ryu DG, Lee SE, Jeon DS, Kim YS, Son BS, Kim do H - Tuberc Respir Dis (Seoul) (2015)

Bottom Line: Interventional lung assist (iLA) effectively reduces CO2 retention and allows protective ventilation in cases of life-threatening hypercapnia.Despite the clinical efficacy of iLA, there are a few major limitations associated with the use of this approach, such as bleeding, thrombosis, and catheter-related limb ischemia.We presented two cases in which thrombotic complications developed during iLA.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.

ABSTRACT
Interventional lung assist (iLA) effectively reduces CO2 retention and allows protective ventilation in cases of life-threatening hypercapnia. Despite the clinical efficacy of iLA, there are a few major limitations associated with the use of this approach, such as bleeding, thrombosis, and catheter-related limb ischemia. We presented two cases in which thrombotic complications developed during iLA. We demonstrated the two possible causes of thrombotic complications during iLA; stasis due to low blood flow and inadequate anticoagulation.

No MeSH data available.


Related in: MedlinePlus

Case 2. Chest spiral computed tomography scan showing filling defect at pulmonary artery (arrow).
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Figure 2: Case 2. Chest spiral computed tomography scan showing filling defect at pulmonary artery (arrow).

Mentions: A 61-year-old man was admitted to the emergency room because of a near-fatal asthma attack. The initial arterial blood gas analysis revealed the following findings: pH, 7.15; PaCO2, 66 mm Hg; PaO2, 66 mm Hg, and O2 saturation 86%. His mental functions gradually decreased despite conventional treatment for asthma. The patient's hypercapnia was intractable under conventional mechanical ventilation (Table 1). As such, iLA support was initiated within 2 hours after intubation with heparin infusion. After iLA insertion, hypercapnia resolved immediately. Extubation was done 32 hours after intubation, and iLA was removed 55 hours after insertion. After the removal of iLA, the patient complained about a new episode of dyspnea. Pulmonary embolism was diagnosed through a computed tomography scan (Figure 2) and anticoagulation treatment was initiated. On the ninth day, he was transferred to his hometown for follow-up treatment.


Thrombotic Complications during Interventional Lung Assist: Case Series.

Kim EJ, Cho WH, Ahn EY, Ryu DG, Lee SE, Jeon DS, Kim YS, Son BS, Kim do H - Tuberc Respir Dis (Seoul) (2015)

Case 2. Chest spiral computed tomography scan showing filling defect at pulmonary artery (arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4311030&req=5

Figure 2: Case 2. Chest spiral computed tomography scan showing filling defect at pulmonary artery (arrow).
Mentions: A 61-year-old man was admitted to the emergency room because of a near-fatal asthma attack. The initial arterial blood gas analysis revealed the following findings: pH, 7.15; PaCO2, 66 mm Hg; PaO2, 66 mm Hg, and O2 saturation 86%. His mental functions gradually decreased despite conventional treatment for asthma. The patient's hypercapnia was intractable under conventional mechanical ventilation (Table 1). As such, iLA support was initiated within 2 hours after intubation with heparin infusion. After iLA insertion, hypercapnia resolved immediately. Extubation was done 32 hours after intubation, and iLA was removed 55 hours after insertion. After the removal of iLA, the patient complained about a new episode of dyspnea. Pulmonary embolism was diagnosed through a computed tomography scan (Figure 2) and anticoagulation treatment was initiated. On the ninth day, he was transferred to his hometown for follow-up treatment.

Bottom Line: Interventional lung assist (iLA) effectively reduces CO2 retention and allows protective ventilation in cases of life-threatening hypercapnia.Despite the clinical efficacy of iLA, there are a few major limitations associated with the use of this approach, such as bleeding, thrombosis, and catheter-related limb ischemia.We presented two cases in which thrombotic complications developed during iLA.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.

ABSTRACT
Interventional lung assist (iLA) effectively reduces CO2 retention and allows protective ventilation in cases of life-threatening hypercapnia. Despite the clinical efficacy of iLA, there are a few major limitations associated with the use of this approach, such as bleeding, thrombosis, and catheter-related limb ischemia. We presented two cases in which thrombotic complications developed during iLA. We demonstrated the two possible causes of thrombotic complications during iLA; stasis due to low blood flow and inadequate anticoagulation.

No MeSH data available.


Related in: MedlinePlus