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Sodium bicarbonate buffer for weaning from venovenous extracorporeal membrane oxygenation in patients with hypercapnic respiratory failure and acute renal failure
Although the routine use of alkali buffer is not recommended in patients with respiratory acidosis, some patients may benefit from its administration. A 42-year-old man was treated with venovenous extracorporeal membrane oxygenation (VV-ECMO) and continuous venovenous hemodiafiltration (CVVHDF) due...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9662079/ https://www.ncbi.nlm.nih.gov/pubmed/36387754 http://dx.doi.org/10.4103/atm.atm_265_22 |
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author | Kim, Sua Hwang, Jinwook Kim, Je Hyeong |
author_facet | Kim, Sua Hwang, Jinwook Kim, Je Hyeong |
author_sort | Kim, Sua |
collection | PubMed |
description | Although the routine use of alkali buffer is not recommended in patients with respiratory acidosis, some patients may benefit from its administration. A 42-year-old man was treated with venovenous extracorporeal membrane oxygenation (VV-ECMO) and continuous venovenous hemodiafiltration (CVVHDF) due to necrotizing pneumonia and emphysematous cystitis with Klebsiella pneumoniae. Although the sweep gas flow rate of the VV-ECMO was gradually reduced, he failed to wean off VV-ECMO due to respiratory acidosis, followed by tachycardia and tachypnea on the 63rd day of VV-ECMO. Therefore, we mixed sodium bicarbonate in the replacement fluid of CVVHDF for 5 days to avoid an intolerable decrease in blood pH after discontinuing the VV-ECMO sweep gas. When the serum bicarbonate concentration was >30 mmol/L and pH was maintained at >7.30 with a PCO2 of >60 mmHg, VV-ECMO was finally decannulated. Sodium bicarbonate buffer through the replacement of CVVHDF fluid facilitated VV-ECMO weaning in a patient with hypercapnic respiratory failure. |
format | Online Article Text |
id | pubmed-9662079 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-96620792022-11-15 Sodium bicarbonate buffer for weaning from venovenous extracorporeal membrane oxygenation in patients with hypercapnic respiratory failure and acute renal failure Kim, Sua Hwang, Jinwook Kim, Je Hyeong Ann Thorac Med Case Report Although the routine use of alkali buffer is not recommended in patients with respiratory acidosis, some patients may benefit from its administration. A 42-year-old man was treated with venovenous extracorporeal membrane oxygenation (VV-ECMO) and continuous venovenous hemodiafiltration (CVVHDF) due to necrotizing pneumonia and emphysematous cystitis with Klebsiella pneumoniae. Although the sweep gas flow rate of the VV-ECMO was gradually reduced, he failed to wean off VV-ECMO due to respiratory acidosis, followed by tachycardia and tachypnea on the 63rd day of VV-ECMO. Therefore, we mixed sodium bicarbonate in the replacement fluid of CVVHDF for 5 days to avoid an intolerable decrease in blood pH after discontinuing the VV-ECMO sweep gas. When the serum bicarbonate concentration was >30 mmol/L and pH was maintained at >7.30 with a PCO2 of >60 mmHg, VV-ECMO was finally decannulated. Sodium bicarbonate buffer through the replacement of CVVHDF fluid facilitated VV-ECMO weaning in a patient with hypercapnic respiratory failure. Wolters Kluwer - Medknow 2022 2022-10-07 /pmc/articles/PMC9662079/ /pubmed/36387754 http://dx.doi.org/10.4103/atm.atm_265_22 Text en Copyright: © 2022 Annals of Thoracic Medicine https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Case Report Kim, Sua Hwang, Jinwook Kim, Je Hyeong Sodium bicarbonate buffer for weaning from venovenous extracorporeal membrane oxygenation in patients with hypercapnic respiratory failure and acute renal failure |
title | Sodium bicarbonate buffer for weaning from venovenous extracorporeal membrane oxygenation in patients with hypercapnic respiratory failure and acute renal failure |
title_full | Sodium bicarbonate buffer for weaning from venovenous extracorporeal membrane oxygenation in patients with hypercapnic respiratory failure and acute renal failure |
title_fullStr | Sodium bicarbonate buffer for weaning from venovenous extracorporeal membrane oxygenation in patients with hypercapnic respiratory failure and acute renal failure |
title_full_unstemmed | Sodium bicarbonate buffer for weaning from venovenous extracorporeal membrane oxygenation in patients with hypercapnic respiratory failure and acute renal failure |
title_short | Sodium bicarbonate buffer for weaning from venovenous extracorporeal membrane oxygenation in patients with hypercapnic respiratory failure and acute renal failure |
title_sort | sodium bicarbonate buffer for weaning from venovenous extracorporeal membrane oxygenation in patients with hypercapnic respiratory failure and acute renal failure |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9662079/ https://www.ncbi.nlm.nih.gov/pubmed/36387754 http://dx.doi.org/10.4103/atm.atm_265_22 |
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