A Case of Exacerbation of Chronic Pulmonary Disease Successfully Treated by an Extracorporeal Lung Assist with a Membrane Lung

Abstract

A 66 year-old male who formerly had tuberculosis which had left severe pleural adhesion in his right chest and compensatory emphysema in the left, developed spontaneous pneumothorax in his left chest and fell into CO₂ narcosis. Air leakage did not cease even after two weeks of continuous suction with a chest tube. Surgical closure of the air leakage seemed impossible due to the minimal respiratory reserve. For fear of deterioration of pulmonary pathology due to the positive pressure of mechanical pulmonary ventilation, a veno-venous extracorporeal lung assist, ECLA, with a Kolobow membrane lung was performed to supplement gas exchange and allow the lungs to rested for natural healing. The patient could speak freely and take food by mouth during ECLA. The air leakage halted within 2 days of ECLA.
Respiratory care with ECLA without endotracheal intubation and mechanical pulmonary ventilation is more acceptable for a conscious patient than the conventional ventilator therapy and may become a new means of respiratory care in the future.