title: Noninvasive ventilation and low-flow veno-venous extracorporeal carbon dioxide removal as a bridge to lung transplantation in a child with refractory hypercapnic respiratory failure due to bronchiolitis obliterans.
abstract: OBJECTIVE
  To report the successful management of end-stage hypercapnic respiratory failure through the association of noninvasive mechanical ventilation and a novel automated device (Decapsmart) of low-flow veno-venous extracorporeal CO2 removal.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Pediatric intensive care unit at a tertiary care children's hospital.
  
  
  METHODS
  A pediatric patient affected by bronchiolitis obliterans with refractory hypercapnic respiratory failure. The patient received successful lung transplantation after respiratory support with noninvasive mechanical ventilation and a novel automated device of low-flow veno-venous extracorporeal CO2 removal.
  
  
  METHODS
  Treatment of end-stage hypercapnic respiratory failure with the association of noninvasive ventilation and low-flow veno-venous extracorporeal CO2 removal as a bridge to lung transplantation.
  
  
  RESULTS
  Respiratory support controlling hypercapnia, limiting volutrauma, barotraumas, and preventing the incidence of ventilator-associated pneumonia/lung colonization.
  
  
  CONCLUSIONS
  Noninvasive mechanical ventilation and Decapsmart have proven efficacious in managing refractory hypercapnic respiratory failure in a pediatric patient awaiting lung transplantation.
authors.affiliation: Istituto Giannina Gaslini, Department of Anesthesia and Intensive Care, Neonatal and Pediatric Intensive Care Unit, Genoa, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Moscatelli
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Ottonello
authors.forename: Laura
authors.initials: L
authors.lastname: Nahum
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Lampugnani
authors.forename: Franco
authors.initials: F
authors.lastname: Puncuh
authors.forename: Alessandro
authors.initials: A
authors.lastname: Simonini
authors.forename: Miriam
authors.initials: M
authors.lastname: Tumolo
authors.forename: Pietro
authors.initials: P
authors.lastname: Tuo
mesh_terms: D001989:Bronchiolitis Obliterans / Q000150:complications*; D002245:Carbon Dioxide / Q000302:isolation & purification; D002675:Child, Preschool; D005112:Extracorporeal Circulation; D006440:Hemofiltration; D006801:Humans; D006935:Hypercapnia / Q000209:etiology; D015278:Intensive Care Units, Pediatric; D016040:Lung Transplantation; D008297:Male; D011175:Positive-Pressure Respiration; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy*
chemical_list: D002245:Carbon Dioxide