[Two cases of severe cytomegalovirus pneumonitis treated with permissive hypercapnia]

Abstract

Two patients with severe cytomegalovirus (CMV) pneumonitis were treated with permissive hypercapnia. Case 1 was a 66-year-old male who suffered ventricular septal perforation caused by acute myocardial infarction. Case 2 was a 54-year-old male who sustained a blunt chest injury. In both cases, hypoxia with reduction of lung compliance developed after their operations. They were mechanically ventilated and we limited their peak inspiratory pressure, disregarding hypercapnia (i.e. permissive hypercapnia). During permissive hypercapnia, the maximum arterial partial pressure of carbon dioxide (PaCO2) was 96 mmHg in case 1 and 141 mmHg in case 2. Duration of hypercapnia (PaCO2 > 50mmHg) was 22 days in case 1 and 29 days in case 2. The patients were weaned from the respirator after two months of mechanical ventilation. In conclusion, the permissive hypercapnia was a useful method in the treatment of severe CMV pneumonitis.