A Case of Status Asthmaticus Treated with Veno-Venous Extracorporeal Membrane Oxygenation and Intratracheal Administration of Adrenaline

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  • Suzuki Ginga
    Department of Critical Care Medicine, Toho University Omori Medical Center
  • Ichibayashi Ryo
    Department of Critical Care Medicine, Toho University Omori Medical Center
  • Yamamoto Saki
    Department of Critical Care Medicine, Toho University Omori Medical Center
  • Watanabe Masayuki
    Department of Critical Care Medicine, Toho University Omori Medical Center
  • Sakai Kota
    Department of Critical Care Medicine, Toho University Omori Medical Center
  • Honda Mitsuru
    Department of Critical Care Medicine, Toho University Omori Medical Center

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Other Title
  • VV-ECMOにアドレナリン気道内散布を併用した喘息重積発作の1例

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<p>Introduction. We herein report a case of severe asthma that was difficult to treat with mechanical ventilation. Case. A 54-year-old man. Medical History. The patient inhaled a β-agonist at the time of an asthma attack, experienced sudden dyspnea, and sought emergency treatment. Procedure. We made a diagnosis of asthma attack and decided to provide ventilatory support. We repeatedly administered intramuscular injections of adrenaline and systemic steroids. However, ventilation failure persisted, and respiratory acidosis progressed. We therefore provided extracorporeal membrane oxygenation (ECMO). A day after the admission, adrenaline was administered to the trachea, and bronchospasm with subsequent improvement was observed. Thereafter, the asthma attack subsided gradually, and the respiratory condition improved. We discontinued ECMO at 63 hours after the indication; the patient was extubated the following day. He was discharged 18 days after admission. Discussion. In cases of asthma attacks that are difficult to treat with mechanical ventilation, prompt ECMO should be performed, and in potentially fatal cases, the intratracheal administration of adrenaline may be useful.</p>

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