Nanomembrane-Based Therapeutic Plasmapheresis after Non-Invasive Ventilation Failure for Treatment of a Patient with Acute Respiratory Distress Syndrome and Myasthenia Gravis: A Case Report

Blood Purif. 2019;48(4):382-384. doi: 10.1159/000502078. Epub 2019 Jul 29.

Abstract

Acute respiratory distress syndrome (ARDS) is characterized by a widespread inflammation of the lungs, causing severe hypoxemia. Several mediators have been associated with it and almost all of them are small enough to be filtrated through a nanomembrane. We present a case report of a 41-year-old man with myasthenia gravis in remission; he developed ARDS caused by pneumonia. Although he performed well on both non-invasive and invasive mechanical ventilation, his oxygenation continued to deteriorate. As a last resort of treatment, we decided to apply nanomembrane-based apheresis to cleanse his plasma from the harmful inflammatory mediators. After 3 sessions of plasmapheresis, his condition improved and he was successfully weaned from mechanical ventilation. The obtained results gave us ground to assume that the removal of bioactive molecules can be a useful adjunct to protective mechanical ventilation in ARDS.

Keywords: Acute respiratory distress syndrome; Apheresis; Nanomembrane; Plasmafilter; Plasmapheresis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Humans
  • Inflammation Mediators / blood
  • Inflammation Mediators / isolation & purification
  • Male
  • Myasthenia Gravis / blood
  • Myasthenia Gravis / complications
  • Myasthenia Gravis / therapy*
  • Noninvasive Ventilation
  • Plasmapheresis / methods*
  • Respiration, Artificial
  • Respiratory Distress Syndrome / blood
  • Respiratory Distress Syndrome / complications
  • Respiratory Distress Syndrome / therapy*

Substances

  • Inflammation Mediators