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


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: 01-10-2011

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


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.

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