Resumo

BONILLA GONZALEZ, Carolina; CAMARGO-AGON, Laura  e  FERNANDEZ-SARMIENTO, Jaime. Ventilatory strategy for carbon dioxide clearance in an infant with persistent hypercapnia. Med. crít. (Col. Mex. Med. Crít.) [online]. 2022, vol.36, n.3, pp.179-182.  Epub 05-Dez-2022. ISSN 2448-8909.  https://doi.org/10.35366/105385.

The experience of combining conventional ventilation and a modified paratracheal gas insufflation technique to avoid complications is presented. An infant with acute respiratory failure secondary to multilobar pneumonia who after start off mechanical ventilation developed pneumothorax, bronchopleural fistulas, and persistent hypercapnic acidemia refractory to conventional ventilatory strategies. It was decided to initiate paratracheal gas insufflation in conventional ventilation in pressure control mode, with 10 L/min of humidified air with a maximum sustained control pressure of 20 cmH2O. Three hours after an improvement in arterial blood gas was recorded and after 72 hours the paratracheal device was removed without complications, with adequate clinical evolution. By not incorporate an intratracheal catheter some complications are avoided, preserving the mechanisms that improve oxygenation and CO2 elimination. Paratracheal gas insufflation is a promising technique, although more studies are required with a greater number of individuals.

Palavras-chave : Hypercapnia; tracheal gas insufflation; pediatrics; critical care; ventilators; mechanical; respiratory insufficiency.

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