Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 15 , ISSUE 4 ( October, 2011 ) > List of Articles

CASE REPORT

Pumpless arteriovenous carbon dioxide removal: A novel simplified strategy for severe asthma in children

Avinash Aravantagi, Kamakshya P. Patra, Suman Shekar, L Keith Scott

Keywords : Arteriovenous carbon dioxide removal, extracorporeal life support, severe asthma

Citation Information : Aravantagi A, Patra KP, Shekar S, Scott LK. Pumpless arteriovenous carbon dioxide removal: A novel simplified strategy for severe asthma in children. Indian J Crit Care Med 2011; 15 (4):224-226.

DOI: 10.4103/0972-5229.92078

License: CC BY-ND 3.0

Published Online: 00-10-2011

Copyright Statement:  Copyright © 2011; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Status asthmaticus unresponsive to pharmacotherapy is conventionally managed with mechanical ventilation, which has its inherent challenges due to barotrauma, dynamic hyperinflation and autopositive end-expiratory pressure (auto-PEEP). Extracorporeal membrane oxygenation has been used as a last resort in respiratory failure due to refractory asthma; however, it entails many complications. In contrast, arteriovenous carbon dioxide removal (AVCO 2 R) is a novel strategy that has been shown to be highly effective in adults with acute respiratory failure. Only one pediatric case series of pediatric asthma managed with AVCO2 R have been published so far. We herein report a case of severe asthma in a 9-year-old boy who developed severe hypercapnia (Pco2 97 mmHg) and acidosis (pH 7.09) despite being on mechanical ventilation. Within 4 h of initiation of AVCO2 R, PCo2 drastically reduced to near-normal levels. He was discharged on day 9 of hospital stay without any complications.


PDF Share
  1. McCormick MC, Kass B, Elixhauser A, Thompson J, Simpson L. Annual report on access to and utilization of health care for children and youth in the United States-1999. Pediatrics 2000;105:219-30.
  2. MacDonnell KF, Moon HS, Sekar TS, Ahluwalia MP. Extracorporeal membrane oxygenator support in a case of severe status asthmaticus. Ann Thorac Surg 1981;31:171-5.
  3. Conrad SA, Zwischenberger JB, Grier LR, Alpard SK, Bidani A. Total extracorporeal arteriovenous carbon dioxide removal in acute respiratory failure: a phase I clinical study. Intensive Care Med 2001;27:1340-51.
  4. Conrad SA, Green R, Scott LK. Near-fatal pediatric asthma managed with pumpless arteriovenous carbon dioxide removal. Crit Care Med 2007;35:2624-9.
  5. Conrad SA, Brown EG, Grier LR, Baier J, Blount J, Heming T, et al. Arteriovenous extracorporeal carbon dioxide removal: a mathematical model and experimental evaluation. ASAIO J 1998;44:267-77.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.