Acute exacerbation of chronic obstructive pulmonary disease (COPD) is commonly treated with different kinds of noninvasive positive pressure and the use of PEEP and NPPV often results in the successful treatment of COPD patients with respiratory distress. Mechanical ventilation, tracheal intubation and sedation became unavoidable in case of deterioration of respiratory distress and gas exchange. These techniques, however, have several side-effects. Moreover the increase in airway resistance may increase hyperinflation during mechanical ventilation, with associated barotrauma and circulatory failure. This may result in a very difficult or impossible weaning. in these cases the use of veno-venous extracorporeal CO2 removal during spontaneous breathing could be a successful strategy to reduce dynamic hyperinflation and to avoid the detrimental effects of tracheal intubation and mechanical ventilation
Beyond mechanical ventilation : extracorporeal CO2 removal in COPD patients / L. Gattinoni. ((Intervento presentato al 2. convegno Congress of Intensive Care Medicine of Serbia tenutosi a Belgrado nel 2013.
Beyond mechanical ventilation : extracorporeal CO2 removal in COPD patients
L. GattinoniPrimo
2013
Abstract
Acute exacerbation of chronic obstructive pulmonary disease (COPD) is commonly treated with different kinds of noninvasive positive pressure and the use of PEEP and NPPV often results in the successful treatment of COPD patients with respiratory distress. Mechanical ventilation, tracheal intubation and sedation became unavoidable in case of deterioration of respiratory distress and gas exchange. These techniques, however, have several side-effects. Moreover the increase in airway resistance may increase hyperinflation during mechanical ventilation, with associated barotrauma and circulatory failure. This may result in a very difficult or impossible weaning. in these cases the use of veno-venous extracorporeal CO2 removal during spontaneous breathing could be a successful strategy to reduce dynamic hyperinflation and to avoid the detrimental effects of tracheal intubation and mechanical ventilationPubblicazioni consigliate
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