RT Book, Section A1 Abrams, Darryl A1 Brodie, Daniel A2 Lee, Kiwon SR Print(0) ID 1143957056 T1 The Role of ECMO in Cardiopulmonary Failure in Adults T2 The NeuroICU Book, 2e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9780071841443 LK neurology.mhmedical.com/content.aspx?aid=1143957056 RD 2024/03/29 AB A 45-year-old man is admitted to the neurologic intensive care unit (NeuroICU) after resection of a craniopharyngioma. Three days into his ICU admission, he has a witnessed aspiration event with subsequent respiratory distress and hypoxemia requiring invasive mechanical ventilation. Over the next 24 hours, his hypoxemic respiratory failure worsens despite increasing mechanical ventilatory support, deep sedation, neuromuscular blockade, and a trial of prone positioning. His chest radiograph demonstrates diffuse bilateral infiltrates. With the patient receiving a fraction of inspired oxygen of 1.0, a positive end-expiratory pressure of 15 cm H2O, a tidal volume of 6 mL/kg of predicted body weight, and a respiratory rate of 35 breaths per minute, arterial blood gas analysis reveals a pH of 7.14, a PaCO2 of 70 mm Hg, and a PaO2 of 50 mm Hg. Plateau airway pressure, measured at end inspiration, is 37 cm H2O.