Extracorporeal carbon dioxide removal using the Novalung in a patient with intracranial bleeding.
A neurosurgical patient who required repeated surgery for intracranial haematoma developed acute respiratory distress syndrome. Raised intracranial pressure proved difficult to manage whilst attempting to maintain optimal gas exchange. The resultant arterial partial pressure of carbon dioxide remained unacceptably high, and treatment by extracorporeal carbon dioxide removal was started. A pumpless arteriovenous interventional lung assist device (Novalung) was connected from the right femoral artery to left femoral vein and reduced the arterial carbon dioxide, corrected the respiratory acidosis and enabled control of the intracranial pressure. Subsequently the requirements for both respiratory and cardiovascular support were reduced. The patient made a complete neurological recovery.
Mallick
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A
Anaesthesia and Intensive Care, Leeds General Infirmary, Leeds, UK. Abhiram.mallick@leedsth.nhs.uk
Elliot
S
S
McKinlay
J
J
Bodenham
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A
D000142:Acidosis, Respiratory / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D000208:Acute Disease; D002245:Carbon Dioxide; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation; D006406:Hematoma / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D020300:Intracranial Hemorrhages / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D007427:Intracranial Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010107:Oxygenators, Membrane; D011659:Pulmonary Gas Exchange / Q000502:physiology*; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome
D002245:Carbon Dioxide