Respiratory Medicine Case Reports (Jan 2024)

Tezepelumab in a case of severe asthma exacerbation and influenza-pneumonia on VV-ECMO

  • E. Grasmuk-Siegl,
  • E. Xhelili,
  • D. Doberer,
  • M.H. Urban,
  • A. Valipour

Journal volume & issue
Vol. 50
p. 102057

Abstract

Read online

We present a case of 43-year-old male patient with broadly by Omalizumab, Mepolizumab and Benralizumab pretreated allergic asthma, who suffered a near fatal exacerbation, triggered by an influenza A infection. Due to massive bronchoconstriction with consecutive hypercapnic ventilatory failure veno-venous ECMO therapy had to be implemented. Hence, guideline directed asthma therapy a substantial bronchodilatation could not be achieved. After administration of a single dose Tezepelumab, a novel TLSP-inhibitor, and otherwise unchanged therapy we documented a significant reduction in intrinsic PEEP measured via a naso-gastric balloon catheter and a narrowing in the expiratory flow curve of the ventilator within 24 hours. The consecutive ventilatory improvement allowed the successful weaning from veno-venous ECMO therapy and invasive ventilation.

Keywords