Management of severe traumatic brain injury and acute respiratory distress syndrome using pumped extracorporeal carbon dioxide removal device. (February 2017)

• Record Type: Journal Article
• Authors: Martindale, Tim; McGlone, Phillip; Chambers, Robert; Fennell, Jon
• Is Part Of: Journal of the Intensive Care Society. Volume 18:Number 1(2017:Feb.)
• Page Start: 66
• Page End: 70
• Publication Date: 2017-02
• Subjects: Carbon dioxide -- severe acute respiratory syndrome -- traumatic brain injury -- extracorporeal circulation -- neuroprotection; Critical care medicine -- Periodicals; Intensive care units -- Periodicals; 616.028
• DOI: 10.1177/1751143716676821
• Languages: English
• ISSNs: 1751-1437

Abstract

The effects of a high carbon dioxide on cerebral perfusion and intracranial pressure are well known. We report the case of a man who presented after with a severe traumatic brain injury including intracranial and extradural haemorrhage. Neuroprotective ventilation was impossible without supramaximal tidal volumes due to a combination of chest trauma and severe bronchospasm. A pump driven Novalung iLA active® system was inserted to achieve both ARDSnet ventilation and a lowering of intracranial pressure. To our knowledge, this is the first time this system has been used to this effect. The patient went on to make a good recovery.