Early Inhaled Nitric Oxide in a Child with ARDS after Intestinal Transplantation

小腸移植後急性呼吸窘迫症候群兒童以早期吸入一氧化氮治療處置

陳芸(Yun Chen) ； 丁曼如(Man-Ju Ting) ； 林蕙鈴(Hui-Ling Lin)

《呼吸治療》 14卷1期 (2015/01) Pp. 21-29

https://doi.org/10.6269/JRT.2015.14.1.03

摘要

小腸移植是罹患腸衰竭兒童的最後治療方式，術後照護及呼吸處置深具挑戰性。高死亡率的急性呼吸窘迫症候群是接受小腸移植後兒童可能產生的嚴重併發症。我們敘述一位10歲女孩接受小腸移植後罹患急性呼吸窘迫症候群，以肺保護策略和早期吸入一氧化氮治療處置的成功案例，而手術後腹部內高壓，臨床人員調整吐氣末正壓時應該更為小心謹慎。

關鍵字

小腸移植 ； 急性呼吸窘迫症候群 ； 肺保護策略 ； 吸入一氧化氮治療 ； 腹部腔室症候群

並列摘要

Intestinal transplantation (IT) is a definitive therapy for children with intestinal failure, yet postoperative care and ventilatory management are challenging. Acute respiratory distress syndrome (ARDS) is a severe complication of IT with high mortality in children. We report a case of a 10-year-old girl who developed ARDS after IT. She was successfully managed with lung protective strategies and early inhaled nitric oxide therapy. The use of PEEP on patients after IT should be cautiously undertaken due to high intra-abdominal pressure.

並列關鍵字

intestinal transplantation ； acute respiratory distress syndrome ； lung protective strategies ； inhaled nitric oxide therapy ； abdominal compartment syndrome