Resumo

LOPEZ-ZAMORA, Venus Nefte; MALDONADO-BELTRAN, Ismael; LUGO-GOYTIA, Gustavo  e  HERNANDEZ-CARDENAS, Carmen Margarita. Esophageal balloon in ECMO: clinical case report. Neumol. cir. torax [online]. 2022, vol.81, n.3, pp.197-200.  Epub 08-Dez-2023. ISSN 0028-3746.  https://doi.org/10.35366/111092.

Severe respiratory distress syndrome, which does not respond to conventional strategies, benefits from veno-venous extracorporeal membrane oxygenation therapy. This bridging therapy can be complemented with lung ultra-protection maneuvers. Transpulmonary pressure may help reduce the risk of ventilator-induced lung injury due to atelectrauma. However, its benefit remains to be established. We present the case of a 34-year-old man with severe acute respiratory failure syndrome receiving veno-venous extracorporeal membrane oxygenation therapy and ultrapulmonary protective ventilation, with positive end-expiratory pressure titration by transpulmonary pressure. Veno-venous extracorporeal membrane oxygenation was successfully decannulated after adequate resolution of the acute respiratory distress syndrome. In this case, it was possible to observe that a ventilation strategy that uses esophageal pressures to estimate transpulmonary pressure significantly improves oxygenation, compliance, and minimizes ventilation-induced lung injury.

Palavras-chave : COVID-19; acute respiratory distress syndrome; extracorporeal membrane oxygenation; esophageal balloon.

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