Clinical use of extracorporeal lung assist for a patient in status asthmaticus.

A 23-year-old man was transferred to our hospital in an unconscious state due to hypercapnea with massive subcutaneous emphysema secondary to status asthmaticus. Mechanical ventilation was ineffective for removal of carbon dioxide and oxygenation. After the initiation of extracorporeal lung assist the patient was able to effectively clear his secretions. This resulted in marked improvement in his pulmonary compliance. There were no hemorrhagic pulmonary or hematologic complications. This is the first patient in whom we have used venovenous bypass in the treatment of status asthmaticus.