J Intensive Care Med. 2017 Jan 1:885066617701117. doi: 10.1177/0885066617701117. [Epub ahead of print]
Is Therapeutic Hypothermia for Acute Respiratory Distress Syndrome the Future?
Hayek AJ1, White HD1, Ghamande S1, Spradley C1, Arroliga AC1.
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Abstract
INTRODUCTION:
Severe acute respiratory distress syndrome (ARDS) has a high mortality, and there is limited knowledge about management of severe ARDS refractory to standard therapy. Early evidence suggests that therapeutic hypothermia (TH) could be a viable treatment for acute respiratory failure. We present 2 cases where TH was successfully used to manage refractory ARDS on extracorporeal membrane oxygenation (ECMO) and a review of the literature around TH and acute respiratory failure.
RESULTS:
We present 2 cases of ARDS secondary to H1N1 influenza and human metapneumovirus. Both patients were treated with the current evidence-based therapy for ARDS. Venovenous ECMO was used in both patients for refractory hypoxemia. Therapeutic hypothermia was applied for 24 hours with improved oxygenation. We did a review of the literature summarizing 38 patients in 10 publications where TH was successfully utilized in the treatment of acute respiratory failure.
CONCLUSION:
Therapeutic hypothermia may be a viable salvage therapy for ARDS refractory to the current evidence-based therapy but needs further evaluation.
KEYWORDS:
acute respiratory distress syndrome; extracorporeal membrane oxygenation; refractory hypoxemia; therapeutic hypothermia
PMID: 28343415 DOI: 10.1177/0885066617701117
Is Therapeutic Hypothermia for Acute Respiratory Distress Syndrome the Future?
Hayek AJ1, White HD1, Ghamande S1, Spradley C1, Arroliga AC1.
Author information
Abstract
INTRODUCTION:
Severe acute respiratory distress syndrome (ARDS) has a high mortality, and there is limited knowledge about management of severe ARDS refractory to standard therapy. Early evidence suggests that therapeutic hypothermia (TH) could be a viable treatment for acute respiratory failure. We present 2 cases where TH was successfully used to manage refractory ARDS on extracorporeal membrane oxygenation (ECMO) and a review of the literature around TH and acute respiratory failure.
RESULTS:
We present 2 cases of ARDS secondary to H1N1 influenza and human metapneumovirus. Both patients were treated with the current evidence-based therapy for ARDS. Venovenous ECMO was used in both patients for refractory hypoxemia. Therapeutic hypothermia was applied for 24 hours with improved oxygenation. We did a review of the literature summarizing 38 patients in 10 publications where TH was successfully utilized in the treatment of acute respiratory failure.
CONCLUSION:
Therapeutic hypothermia may be a viable salvage therapy for ARDS refractory to the current evidence-based therapy but needs further evaluation.
KEYWORDS:
acute respiratory distress syndrome; extracorporeal membrane oxygenation; refractory hypoxemia; therapeutic hypothermia
PMID: 28343415 DOI: 10.1177/0885066617701117