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Extacorporeal lung assist (ECLA) for a premature infalnt with severe barotraunla as a sequeli of mechanical pulmonary ventilation Tadashi Tanoue 1 , Hidemori Terasaki 1 , Kanemitsu Higashi 1 , Keiji Goto 1 , Kazuyuki Masuda 1 , Taisuke Okamoto 1 , Michi-aki Sadanaga 1 , Ryuji Tutumi 1 , Kyoji Tsuno 1 , Tohru Morioka 1 , Shinichi Tomoeda 2 , Ryouichi Matsuoka 2 , Toshihide Sato 2 , Kazufumi Okamoto 2 , Hirotada Katsuya 2 , Noriyoshi Kawasaki 3 1Department of Anesthesiology, Kumamoto University Medical School 2Intensive Care Unit, Kumamoto University Hospital 3Department of Obstetrics & Gynecology, Kumamoto University Medical School pp.999-1003
Published Date 1988/9/15
DOI https://doi.org/10.11477/mf.1404205328
  • Abstract
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An infant with a body weight of 2000 g was delivered by Cesarean section at 34 weeks and one day of gestation from a mother with severe toxemia. Typical findings of RDS (Bomsel IV) were noted shortly after birth, and he was transferred to the Intensive Care Unit at Kumamoto University Hos-pital. During mechanical pulmonary ventilation for respiratory immaturity, the infant developed severe ventilation difficulties due to pneumothorax of the right chest and progressing mediastinal emphysema on the third day after birth.

For a life threatening PaO2 of 55 mmHg, a PaCO2 of 150 ininHg, and a pH 6.65 under maximal mechani-cal ventilation, venovenous extracorporeal lung assist (ECLA) with a hollow-fiber-oxygenator, Mera Silox, was performed through a single lumen cannula inserted into the right jugular vein. Under respira-tory support with ECLA, blood gases were main-tained within their normal limit, and mechanical ventilation could be turned down to the minimum to keep the lung at rest. Remarkable improvement of the lung pathology was noted within 24 hrs and ECLA was switched to the conventional ventilator therapy within four days. Though the patient died of neurological disorders as a sequence of intracra-nial hemorrhage 77 days after birth, ECLA once afforded this patient a chance to survive severe respiratory failure.

ECLA will become a new means of life support for the newborn and infants with severe cardiopul-monary failure.


Copyright © 1988, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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