Pumpless extracorporeal carbon dioxide removal for life-threatening asthma

Abstract

Objective: To report the use of pumpless extracorporeal carbon dioxide removal in two cases of acute severe asthma.

Design: Case reports.

Setting: Adult general intensive care unit, Leeds General Infirmary, Leeds, UK.

Patients: A 74-yr-old male and 52-yr-old female with life-threatening asthma developed progressive hypercapnia and severe acidosis that proved nonresponsive to all other therapies.

Intervention: Initiation of extracorporeal arteriovenous carbon dioxide removal using the Novalung device (Novalung GmbH, Lotzenäcker 3, D-72379 Hechingen, Germany).

Main results: The addition of extracorporeal carbon dioxide removal to mechanical ventilation corrected hypercapnia and acidosis, allowing reduction of other supportive measures. In both cases, adequate gas exchange was maintained until their underlying condition improved sufficiently for device removal. The two patients were subsequently weaned from mechanical ventilation and made a full recovery.

Conclusions: Extracorporeal carbon dioxide removal proved to be a valuable adjunct to mechanical ventilation and other medical treatment.