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.
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.
Moscatelli
Andrea
A
Istituto Giannina Gaslini, Department of Anesthesia and Intensive Care, Neonatal and Pediatric Intensive Care Unit, Genoa, Italy.
Ottonello
Giancarlo
G
Nahum
Laura
L
Lampugnani
Elisabetta
E
Puncuh
Franco
F
Simonini
Alessandro
A
Tumolo
Miriam
M
Tuo
Pietro
P
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*
D002245:Carbon Dioxide