Critically Ill Patient with Acute Exacerbation of Chronic Obstructive Pulmonary Disease Developing Sepsis and Potassium Disorder: a Case Report in Secondary Hospital Setting

Regia Anadhia Pinastika, Indah Rahmawati, Tiara Nadya Putrianda
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Abstract

Sepsis and electrolyte disturbances are frequently experienced among acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients. It is characterized by organ failure brought on by unbalanced host response to infection. A 63-year-old male presented to the hospital with the complaint of breathlessness with the oxygen saturation of 76%. The leukocyte level increased to 19.000 and the Potassium level decreased to 2.88. The combination of antibiotics, Potassium supplement, oxygen support through NRM of 15 liters per minute and symptomatic treatment were administered to the patient. The NRM was then changed to HFNC due to his worsening condition and successfully decreased oxygen demand. The patient’s condition has made a significant improvement after seven days of hospitalization. Patients with AECOPD are at higher risk of developing sepsis and electrolyte disturbances. Sepsis will change the biological system of the body due to different pathophysiology such as electrolyte imbalance and obviously engaged with the pathogenesis of ensuing regular intensifications. It is important for the clinicians to know the effective management for the patient, so that the critical phase can be passed even at the limited facilities. 
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慢性阻塞性肺疾病急性加重并发败血症和钾血症的危重患者:二级医院一例报告
脓毒症和电解质紊乱在慢性阻塞性肺疾病(AECOPD)急性加重期患者中经常发生。它的特点是由宿主对感染的不平衡反应引起的器官衰竭。男,63岁,主诉呼吸困难,血氧饱和度76%。白细胞水平上升至19.000,钾水平下降至2.88。给予抗生素联合补钾、NRM给氧15升/分及对症治疗。由于病情恶化,将NRM改为HFNC,并成功降低了需氧量。病人住院7天后,病情有了明显好转。AECOPD患者发生败血症和电解质紊乱的风险更高。脓毒症会因电解质失衡等不同的病理生理改变机体的生物系统,并与随后的规律强化的发病机制明显相关。对于临床医生来说,了解对患者的有效管理是很重要的,这样即使在有限的设备下也能度过关键阶段。
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