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Bilateral phrenic nerve block to reduce hazardous respiratory drive in a mechanically ventilated patient with COVID-19-A case report.

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العنوان: Bilateral phrenic nerve block to reduce hazardous respiratory drive in a mechanically ventilated patient with COVID-19-A case report.
المؤلفون: Levis A; Department of Intensive Care Medicine, Inselspital, Bern University Hospital University of Bern Bern Switzerland.; Department of Anesthesiology and Pain Medicine, Inselspital, Bern University Hospital University of Bern Bern Switzerland., Gardill M; Department of Intensive Care Medicine, Inselspital, Bern University Hospital University of Bern Bern Switzerland., Bachmann KF; Department of Intensive Care Medicine, Inselspital, Bern University Hospital University of Bern Bern Switzerland., Berger D; Department of Intensive Care Medicine, Inselspital, Bern University Hospital University of Bern Bern Switzerland., Schandl C; Department of Intensive Care Medicine Cantonal Hospital Winterthur Winterthur Switzerland., Piquilloud L; Adult Intensive Care Unit, Lausanne University Hospital (CHUV) University of Lausanne Lausanne Switzerland., Haenggi M; Department of Intensive Care Medicine, Inselspital, Bern University Hospital University of Bern Bern Switzerland.
المصدر: Clinical case reports [Clin Case Rep] 2024 May 07; Vol. 12 (5), pp. e8850. Date of Electronic Publication: 2024 May 07 (Print Publication: 2024).
نوع المنشور: Case Reports
اللغة: English
بيانات الدورية: Publisher: John Wiley & Sons Country of Publication: England NLM ID: 101620385 Publication Model: eCollection Cited Medium: Print ISSN: 2050-0904 (Print) Linking ISSN: 20500904 NLM ISO Abbreviation: Clin Case Rep Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Chichester, UK : John Wiley & Sons
مستخلص: Key Clinical Message: Forced inspiration during mechanical ventilation risks self-inflicted lung injury. However, controlling it with sedation or paralysis may cause polyneuropathy and myopathy. We tested bilateral phrenic nerve paralysis with local anesthetic in a patient, showing reduced inspiratory force. This offers an alternative to drug-induced muscle paralysis.
Abstract: Mechanical ventilation, although a life-saving measure, can also pose a risk of causing lung injury known as "ventilator-induced lung injury" or VILI. Patients undergoing mechanical ventilation sometimes exhibit heightened inspiratory efforts, wherein the negative pressure generated by the respiratory muscles adds to the positive pressure generated by the ventilator. This combination of high pressures can lead to a syndrome similar to VILI, referred to as "patient self-inflicted lung injury" or P-SILI. Prevention of P-SILI requires the administration of deep sedation and muscle paralysis to the patients, but both these measures can have undesired effects on their health. In this case report, we demonstrate the effect of a bilateral phrenic nerve block aiming to reduce excessive inspiratory respiratory efforts in a patient suffering from COVID-19 pneumonitis.
Competing Interests: The authors declare that they do not have any conflict of interest regarding this case report.
(© 2024 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)
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فهرسة مساهمة: Keywords: ARDS prevention and control; ARDS therapy; SARS‐CoV‐2 infection; acute respiratory distress syndrome
تواريخ الأحداث: Date Created: 20240509 Latest Revision: 20240510
رمز التحديث: 20240510
مُعرف محوري في PubMed: PMC11077186
DOI: 10.1002/ccr3.8850
PMID: 38721551
قاعدة البيانات: MEDLINE
الوصف
تدمد:2050-0904
DOI:10.1002/ccr3.8850