[A case of severe acute respiratory distress syndrome caused by inhalation injury].

C H Gu, X M Li, X W Kang
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Abstract

A 54-year-old male patient with severe acute respiratory distress syndrome caused by inhalation injury was admitted to the First People's Hospital of Lianyungang City on June 26th, 2022. After admission, the patient received invasive mechanical ventilation (driving pressure-guided ventilator parameter setting) combined with prone position treatment immediately, but his condition continued to deteriorate. Five hours after admission, the patient received veno-venous extracorporeal membrane oxygenation (VV-ECMO) supporting treatment, treatment based on ultra-protective lung ventilation strategy combined with prone position ventilation for more than 12 hours per day. At the same time, pulse contour cardiac output monitoring technology was used to monitor cardiac index and extravascular lung water index to guide volume management, and fiberoptic bronchoalveolar lavage was performed for several times. After that, the patient was successfully weaned from VV-ECMO and ventilator, and then discharged from hospital successfully. During follow-up of one year after the injury, the patient showed no obvious respiratory symptoms, and his lung function was basically normal.

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[一例因吸入损伤引起的严重急性呼吸窘迫综合征]。
2022 年 6 月 26 日,连云港市第一人民医院收治了一名因吸入性损伤导致严重急性呼吸窘迫综合征的 54 岁男性患者。入院后,患者立即接受有创机械通气(驱动压力引导呼吸机参数设置)联合俯卧位治疗,但病情持续恶化。入院5小时后,患者接受了静脉-体外膜肺氧合(VV-ECMO)辅助治疗,治疗以超保护肺通气策略为主,结合俯卧位通气,每天治疗12小时以上。同时,利用脉搏轮廓心输出量监测技术监测心指数和血管外肺水指数,指导容量管理,并多次进行纤维支气管肺泡灌洗。随后,患者成功脱离 VV-ECMO 和呼吸机,并顺利出院。伤后随访一年,患者无明显呼吸道症状,肺功能基本正常。
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期刊介绍: The Chinese Journal of Burns is the most authoritative one in academic circles of burn medicine in China. It adheres to the principle of combining theory with practice and integrating popularization with progress and reflects advancements in clinical and scientific research in the field of burn in China. The readers of the journal include burn and plastic clinicians, and researchers focusing on burn area. The burn refers to many correlative medicine including pathophysiology, pathology, immunology, microbiology, biochemistry, cell biology, molecular biology, and bioengineering, etc. Shock, infection, internal organ injury, electrolytes and acid-base, wound repair and reconstruction, rehabilitation, all of which are also the basic problems of surgery.
期刊最新文献
[A case of severe acute respiratory distress syndrome caused by inhalation injury]. [A randomized controlled trial on the effect of exercise prescription based on a progressive mode in treating elderly patients with lower limb dysfunction after deep burns]. [Anatomical study of the architecture of the cutaneous branch-chained blood vessels in the medial lower leg in adult]. [Clinical effect of free posterior interosseous artery perforator flap carrying superficial vein for reconstructing severe perioral scar hyperplasia and contracture]. [Clinical effects of different types of tissue flaps in repairing the wounds with steel plate exposure and infection after proximal tibial fracture surgery].
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