Advanced Search

Home > Journals > Minerva Anestesiologica > Past Issues > Minerva Anestesiologica 2012 March;78(3) > Minerva Anestesiologica 2012 March;78(3):385-9



A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,036

Frequency: Monthly

ISSN 0375-9393

Online ISSN 1827-1596


Minerva Anestesiologica 2012 March;78(3):385-9


Long-term extracorporeal membrane oxygenation with minimal ventilatory support: a new paradigm for severe ARDS?

Mauri T. 1, 2, Foti G. 2, Zanella A. 1, 2, Bombino M. 2, Confalonieri A. 1, 2, Patroniti N. 1, 2, Bellani G. 1, 2, Pesenti A. 1, 2

1 Department of Experimental Medicine, Milan-Bicocca University, Monza, Italy;
2 Department of Perioperative Medicine and Intensive Care, San Gerardo Hospital, Monza, Italy

Pulmonary tuberculosis can lead to acute respiratory distress syndrome (ARDS) which is associated with high mortality. We report the case of a patient with pulmonary tuberculosis and severe ARDS (PaO2/FiO2<100 mmHg) who was initially managed with advanced up-to-date treatments (protective ventilation and extracorporeal membrane oxygenation, ECMO) but failed to improve. After a month of failure and the development of bilateral pneumothoraces, we drastically changed our therapeutic strategy: we maximized ECMO support to maintain oxygenation, we greatly reduced ventilation pressures and we left the pneumothoraces undrained. From then on, the patient improved and he eventually survived. This case suggests that ECMO permits large reductions in lung inflation and ventilation to rest the lungs, while maintaining acceptable oxygenation. The combination of ECMO and markedly attenuated ventilation strategy may be effective in cases of severe ARDS.

language: English


top of page