Controlled mechanical hypoventilation in a paediatric burn patient as treatment of acute respiratory distress syndrome.
The paediatric patient we are describing suffered a scald injury covering 83 per cent of the total body surface area (TBSA). This injury was complicated by Klebsiella pneumoniae septicaemia resulting in multiorgan failure (MOF). Acute respiratory distress syndrome (ARDS), gastrointestinal insufficiency, hepathopathy and wound conversion to full thickness posed the main problems. The boy was ventilated with pressure-controlled mechanical ventilation. The concept of permissive hypercapnia (PHC) resulted in a complete resolution of ARDS within 4 weeks. From our experience, further lung injury among infants and children suffering from severe ARDS can be avoided by using controlled mechanical hypoventilation. It is a simple and safe technique that allows adequate oxygenation.
Trop
M
M
Department of Pediatrics, University of Graz, Austria.
Zobel
G
G
Waniek
E
E
Waniek
G
G
Bärnthaler
J
J
Grubbauer
H M
HM
D000061:Accidents, Home; D016470:Bacteremia / Q000150:complications / Q000628:therapy*; D002056:Burns / Q000150:complications* / Q000628:therapy; D018572:Disease-Free Survival; D006801:Humans; D007040:Hypoventilation; D007223:Infant; D007231:Infant, Newborn; D007710:Klebsiella Infections / Q000150:complications / Q000628:therapy*; D008297:Male; D009102:Multiple Organ Failure / Q000209:etiology / Q000628:therapy*; D012121:Respiration, Artificial / Q000379:methods*; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications / Q000628:therapy*; D012129:Respiratory Function Tests