title: The successful management of a patient with exacerbation of non-cystic fibrosis bronchiectasis and bilateral fibrothorax using a venovenous extracorporeal carbon dioxide removal system.
abstract: Following unsuccessful treatment with noninvasive ventilation (NIV), patients requiring subsequent placement on invasive mechanical ventilation have a high mortality rate. Invasive mechanical ventilation is particularly problematic in patients with acute respiratory failure due to bronchiectasis exacerbation, as it is associated with a mortality rate of 19-35% and prolonged ICU stay. Here, we describe the successful management of a patient with exacerbated non-cystic fibrosis bronchiectasis using a pump-assisted venovenous system for extracorporeal CO2 removal (ProLUNG system) as an alternative to endotracheal intubation following NIV failure. The extracorporeal CO2 removal system proved to be safe and efficacious in this case study, and further studies focusing on its use in these types of cases seem warranted.
authors.affiliation: Respiratory Intensive Care Unit, City Hospital of Padova, Padova, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Arcaro
authors.affiliation: Respiratory Intensive Care Unit, City Hospital of Padova, Padova, Italy. avianello@qubisoft.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Vianello
mesh_terms: D000328:Adult; D001987:Bronchiectasis / Q000150:complications*; D002245:Carbon Dioxide / Q000097:blood; D002405:Catheterization, Central Venous; D005112:Extracorporeal Circulation; D005355:Fibrosis / Q000150:complications; D006801:Humans; D006935:Hypercapnia / Q000097:blood / Q000209:etiology / Q000628:therapy*; D008297:Male; D063087:Noninvasive Ventilation; D035422:Pleural Cavity / Q000473:pathology*; D012131:Respiratory Insufficiency / Q000097:blood / Q000209:etiology / Q000628:therapy*; D019233:Retreatment; D017211:Treatment Failure
chemical_list: D002245:Carbon Dioxide
keywords: bronchiectasis; extracorporeal CO2 removal; noninvasive ventilation