Successful extracorporeal life support for life-threatening hypercapnia with bronchiolitis obliterans after allogeneic hematopoietic stem cell transplantation

Acta Med Okayama. 2011 Dec;65(6):403-6. doi: 10.18926/AMO/47266.

Abstract

Bronchiolitis obliterans (BO) is a disease with a poor prognosis, and a key factor that limits long-term survival after allogeneic hematopoietic stem cell transplantation (HSCT). We here report a case of a 31-year woman with acute lymphatic leukemia, which was treated by chemotherapy and HSCT, and consequently developed BO 2 years after HSCT. A non-tuberculous mycobacterial infection occurred and showed gradual exacerbation. She started taking anti-mycobacterial drugs, but lost appetite, felt tired and finally lost consciousness one month after beginning medication. Arterial blood gas revealed marked hypercapnia. Using extracorporeal life support (ECLS), the carbon dioxide concentration was reduced and her consciousness recovered. To our knowledge, this is the first case in which ECLS was successfully used for hypercapnia in a patient with BO.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Bronchiolitis Obliterans / complications*
  • Bronchiolitis Obliterans / etiology*
  • Bronchiolitis Obliterans / mortality
  • Carbon Dioxide / blood
  • Extracorporeal Circulation / statistics & numerical data*
  • Female
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Hypercapnia / etiology*
  • Hypercapnia / mortality
  • Hypercapnia / therapy*
  • Life Support Systems*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / surgery
  • Transplantation, Homologous / adverse effects

Substances

  • Carbon Dioxide