title: Successful extracorporeal life support for life-threatening hypercapnia with bronchiolitis obliterans after allogeneic hematopoietic stem cell transplantation.
abstract: Bronchiolitis obliterans (BO) is a disease with a poor prognosis, and a key factor that limits long-term survival after allogeneic hematopoietic stem cell transplantation (HSCT). We here report a case of a 31-year woman with acute lymphatic leukemia, which was treated by chemotherapy and HSCT, and consequently developed BO 2 years after HSCT. A non-tuberculous mycobacterial infection occurred and showed gradual exacerbation. She started taking anti-mycobacterial drugs, but lost appetite, felt tired and finally lost consciousness one month after beginning medication. Arterial blood gas revealed marked hypercapnia. Using extracorporeal life support (ECLS), the carbon dioxide concentration was reduced and her consciousness recovered. To our knowledge, this is the first case in which ECLS was successfully used for hypercapnia in a patient with BO.
authors.affiliation: Department of Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Waseda
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Tanimoto
authors.forename: Shingo
authors.initials: S
authors.lastname: Ichiba
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Miyahara
authors.forename: Toshi
authors.initials: T
authors.lastname: Murakami
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Ochi
authors.forename: Michihisa
authors.initials: M
authors.lastname: Terado
authors.forename: Osamu
authors.initials: O
authors.lastname: Nagano
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Maeda
authors.forename: Arihiko
authors.initials: A
authors.lastname: Kanehiro
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Ujike
authors.forename: Mitsune
authors.initials: M
authors.lastname: Tanimoto
mesh_terms: D000328:Adult; D001989:Bronchiolitis Obliterans / Q000150:complications* / Q000209:etiology* / Q000401:mortality; D002245:Carbon Dioxide / Q000097:blood; D005112:Extracorporeal Circulation / Q000706:statistics & numerical data*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D006935:Hypercapnia / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D008021:Life Support Systems; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000601:surgery; D014184:Transplantation, Homologous / Q000009:adverse effects
chemical_list: D002245:Carbon Dioxide