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Kokyu to Junkan Volume 37, Issue 3 （March 1989）

呼吸と循環 37巻3号（1989年3月発行）

Japanese English

症例

針状オガ屑吸引による急性気道閉塞患者のECLAによる救命例 A case of acute airway obstruction with sharp sawdust particles, successfully treated by extracorporeal lung assist 東兼充 ¹ , 竹下次郎 ¹ , 寺崎秀則 ¹ , 田上正 ¹ , 江崎公明 ¹ , 坂元正克 ¹ , 堤隆治 ¹ , 岸泰至 ¹ , 矢野敏之 ¹ , 大津哲郎 ¹ , 森岡亨 ¹ , 重本達弘 ² , 堂籠博 ² , 今岡秀俊 ² , 坂梨祐司 ² , 岡元和文 ² , 勝屋弘忠 ² , 加納竜彦 ³ Kanemitsu Higashi ¹ , Tirou Takeshita ¹ , Hidenori Terasaki ¹ , Tadashi Tanoue ¹ , Kimiaki Esaki ¹ , Masakatsu Sakamoto ¹ , Ryuji Tsutsumi ¹ , Hiroshi Kishi ¹ , Tosiyuki Yano ¹ , Teturou Ootsu ¹ , Tohru Morioka ¹ , Tatsuhiro Shizemoto ² , Hiroshi Dohgomori ² , Hidetoshi Imaoka ² , Yuji Sakanashi ² , Kazufumi Okamoto ² , Hirotada Katsuya ² , Tatsuhiko Kanou ³ ¹熊本大学医学部麻酔学教室 ²熊本大学医学部付属病院集中治療部 ³熊本大学医学部付属病院中央手術部 ¹Department of Anesthesiology, Kumamoto University Medical School ²Intensive Care Unit, Kumamoto University Hospital ³Surgical Center, Kumamoto University Hospital pp.329-333

発行日 1989年3月15日 Published Date 1989/3/15

DOI https://doi.org/10.11477/mf.1404205446

PDF(10746KB)

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Abstract 文献概要
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　オガ屑を誤って気道内に多量吸引し，重篤な気道閉塞状態に陥った患者に，膜型人工肺を用いた体外式肺補助（extracorporeal lung assist：　ECLAと略す）で呼吸を補助しながら気道内異物を除去し無事救命しえた貴重な症例を経験したので報告する。

A 17 year-old male accidentally fell into a loading shute filled with sharp particles of sawdust. He aspirated a large amount of sawdust and suffered from acute airway obstruction accompanied by barot-rauma, probably due to severe cough and tissue damage from the needle sharp sawdust particles.Ordinary mechanical ventilation was not enough to keep normal gas exchange. To sustain life, a veno-venous extracorporeal lung assist, ECLA, with two Kolobow membrane lungs was performed.

Under ECLA, the sawdust particles were remo-ved from the airway one by one with a broncho-fiber scope taking almost 10 hours. Then the left lung lavage was performed with normal saline to remove finer sawdust. The patient survived these procedures and was weaned from ECLA after 36 hrs. His recovery was uneventful.