Successful treatment of a severely injured soldier from Afghanistan with pumpless extracorporeal lung assist and neurally adjusted ventilatory support
Successful treatment of a severely injured soldier from Afghanistan with pumpless extracorporeal lung assist and neurally adjusted ventilatory support
复制标题
DOI：
10.1007/s12245-010-0192-x
复制
发表时间：
2010-01-01
影响因子：
3.2
通讯作者：
Graf, Bernhard M.
中科院分区：
文献类型：
--
作者：
Bein, Thomas;Osborn, Eric;Graf, Bernhard M.
背景：战斗和/或恐怖袭击造成的危及生命的急性肺损伤与高死亡率相关。成功的管理包括使用“抢救”体外肺辅助和由航空医疗后送队及早运送。目的描述无泵体外动静脉肺辅助治疗重症高碳酸血症/低氧血症的重伤员院前支持。方法一名英国士兵在阿富汗遭受严重的胸部和腹部枪伤。外伤性肺切除术后，他出现了严重的高碳酸血症/低氧血症。他接受机械通气和无泵介入体外肺辅助（iLA, Novalung, Talheim，德国），并转移到德国。结果充分的CO2抽吸和氧合的改善有利于安全运输和肺保护性通气。新型神经调节通气辅助（NAVA）的应用促进了机械通气的脱机。病人已康复，离开德国时情况稳定。结论新型体外肺辅助技术和通气支持技术在灾难医学中也可以挽救生命。
Background Life-threatening acute lung injury due to combat and/or terror attacks is associated with high mortality. The successful management includes the use of "rescue" extracorporeal lung assist and early transport by aeromedical evacuation teams.Aims Description of the pre-hospital support of a severely injured soldier with a pumpless extracorporeal arteriovenous lung assist in critical hypercapnia/hypoxemia.Method A British soldier suffered from severe gunshot injuries to the chest and abdomen in Afghanistan. After traumatic pneumonectomy, he developed critical hypercapnia/hypoxemia. He was mechanically ventilated and supported with a pumpless interventional extracorporeal lung assist (iLA, Novalung, Talheim, Germany) and transferred to Germany.Results A sufficient CO2 extraction and improvement in oxygenation enabled the safe transportation and lung protective ventilation. Weaning from mechanical ventilation was promoted by the application of a new neurally adjusted ventilatory assist (NAVA). The patient recovered, and he left Germany in stable condition.Conclusion Novel techniques in extracorporeal lung assist and in ventilatory support may help save lives even in disaster medicine.