JaLCDOI 10.18926/AMO/47266
FullText URL 65_6_403.pdf
Author Waseda, Koichi| Tanimoto, Yasushi| Ichiba, Shingo| Miyahara, Nobuaki| Murakami, Toshi| Ochi, Nobuaki| Terado, Michihisa| Nagano, Osamu| Maeda, Yoshinobu| Kanehiro, Arihiko| Ujike, Yoshihito| Tanimoto, Mitsune|
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.
Keywords extracorporeal life support hypercapnia bronchiolitis obliterans noninvasive positive pressure ventilation
Amo Type Case Report
Publication Title Acta Medica Okayama
Published Date 2011-12
Volume volume65
Issue issue6
Publisher Okayama University Medical School
Start Page 403
End Page 406
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 22189481
Web of Science KeyUT 000298516900007
Author Taniguchi, Akihiko| Miyahara, Nobuaki| Nakahara, Atsushi| Takata, Saburo| Sakugawa, Ryo| Nagano, Osamu| Tanimoto, Yasushi| Kanehiro, Arihiko| Kiura, Katsuyuki| Ujike, Yoshito| Tanimoto, Mitsune|
Published Date 2011-12-01
Publication Title 岡山医学会雑誌
Volume volume123
Issue issue3
Content Type Journal Article
JaLCDOI 10.18926/AMO/30963
FullText URL fulltext.pdf
Author Terado, Michihisa| Ichiba, Shingo| Nagano, Osamu| Ujike, Yoshihito|
Abstract

In modern emergency and critical care, physicians tend to choose the mode of mechanical ventilation based on spontaneous breathing for the purpose of promoting discharge of pulmonary secretion and preventing atelectasis in patients with acute respiratory insufficiency. However, we often observe "differences in recovery" among patients treated using the same PSV settings beyond "differences in individual characteristics." We evaluated the Pressure Support Ventilation (PSV) mode aiming to certify the difference among 7 representative mechanical ventilators using the Active Servo Lung 5000 (ASL5000) respiratory simulation system. The following parameters were measured: The time delay that resulted in the lowest inspiratory pressure from the point at which the ventilator recognized spontaneous breathing (TD), the lowest inspiratory airway pressure (cmH2O) generated prior to the initiation of PSV (DeltaPaw), the work of breathing while triggering required to achieve the lowest inspiratory negative pressure from the beginning of inspiratory support (WOBtrig), and the inspiratory work of breathing (WOBi). The mean TD of the Puritan-Bennett type 840 (PB840) was signifi cantly shorter than those of other ventilators (p0.01). The WOBtrig of the PB840 was significantly lower than those of others (p0.01). However, the WOBi values of the Servo-I and T-Bird were greater than the others, with the Evita series showing the smallest WOBi of the 7 ventilators tested. According to this simulation study using ASL 5000, we concluded that PB840 was the most rapid response ventilator, but the Evita series was the gentlest mechanical ventilator among 7 ventilators from the standpoint of the total work of breathing during the inspiration phase in the setting of PSV.

Keywords work of breathing pressure support ventilation mechanical ventilation active servo lung (ASL5000)
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2008-04
Volume volume62
Issue issue2
Publisher Okayama University Medical School
Start Page 127
End Page 133
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
File Version publisher
Refereed True
PubMed ID 18464889
Web of Science KeyUT 000255297600009