Veno-venous extracorporeal membrane oxygenation for acute respiratory distress syndrome caused by nitrogen dioxide inhalation: A case report

IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL Acute Medicine & Surgery Pub Date : 2024-04-24 DOI:10.1002/ams2.957

Tomoya Nishimura, Makoto Aoki, Hiroyuki Suzuki, Hiroya Hagiwara, Akira Kawauchi, Kenji Fujizuka, Mitsunobu Nakamura

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Abstract

Background

Nitrogen dioxide (NO₂) is known to cause lung injury, but there is no established treatment for acute respiratory distress syndrome (ARDS) caused by NO₂ inhalation.

Case Presentation

A 35-year-old man was accidentally exposed to NO₂ fumes and presented to the emergency department. On admission, his oxygen saturation was 87% on ambient air and he was diagnosed with ARDS caused by NO₂ inhalation and immediately intubated; however, hypoxemia and hypercapnia were not ameliorated. Hence, veno-venous extracorporeal membrane oxygenation (V-V ECMO) was introduced and the ventilator settings were set for lung-protective ventilation. Methylprednisolone was also administered. After the initiation of these treatments, oxygenation gradually improved. Therefore, ECMO was weaned off on day 11 and he was extubated on day 12.

Conclusion

Lung injury caused by NO₂ inhalation can cause ARDS, and lung-protective ventilation with V-V ECMO induction, as well as glucocorticoid administration, may be effective for this condition.

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静脉体外膜氧合治疗二氧化氮吸入导致的急性呼吸窘迫综合征：病例报告

背景众所周知，二氧化氮（NO2）会造成肺损伤，但对于吸入二氧化氮引起的急性呼吸窘迫综合征（ARDS），目前还没有成熟的治疗方法。病例介绍一名 35 岁的男子因意外接触到二氧化氮烟雾而被送往急诊科。入院时，他在环境空气中的血氧饱和度为 87%，被诊断为吸入二氧化氮导致的急性呼吸窘迫综合征，并立即进行了插管；然而，低氧血症和高碳酸血症并未得到改善。因此，他接受了静脉-静脉体外膜氧合（V-V ECMO），并将呼吸机设置为肺保护通气。同时还使用了甲基强的松龙。开始这些治疗后，氧合情况逐渐改善。因此，在第 11 天断开了 ECMO，并在第 12 天拔除了插管。结论吸入二氧化氮引起的肺损伤可导致 ARDS，V-V ECMO 诱导的肺保护性通气以及糖皮质激素的应用对这种情况可能有效。

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来源期刊

Acute Medicine & Surgery MEDICINE, GENERAL & INTERNAL-

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12.50%

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审稿时长

53 weeks