Severe Acute Respiratory Distress Syndrome (ARDS) or Severely Increased Chest Wall Elastance?

Simon Lindner; Daniel Dürschmied; Ibrahim Akin; Simone Britsch

doi:10.7759/cureus.22541

Severe Acute Respiratory Distress Syndrome (ARDS) or Severely Increased Chest Wall Elastance?

Cureus. 2022 Feb 23;14(2):e22541. doi: 10.7759/cureus.22541. eCollection 2022 Feb.

Authors

Simon Lindner^{1

2}, Daniel Dürschmied^{1

2}, Ibrahim Akin^{1

2}, Simone Britsch^{1

2}

Affiliations

¹ Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Center Mannheim, Mannheim, DEU.
² European Center for Angioscience (ECAS) and German Center for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, Mannheim, DEU.

Abstract

Esophageal manometry can be used to calculate transpulmonary pressures and optimize ventilator settings accordingly. We present the case of a 31-year-old male patient with ataxia-telangiectasia (Louis-Bar syndrome) and a BMI of 20 kg/m², admitted to our intensive care unit for coronavirus disease 2019 (COVID-19) pneumonia. The patient soon required mechanical ventilation; however, there was very poor respiratory system compliance. Cholecystitis complicated the clinical course, and veno-venous extracorporeal membrane oxygenation (ECMO) was initiated as gas exchange deteriorated. Esophageal manometry was introduced and revealed severely increased intrathoracic pressure and chest wall elastance.

Keywords: acute respiratory distress syndrome; covid-19; esophageal manometry; extracorporeal membrane oxygenation; transpulmonary pressure.

Publication types

Case Reports