Gauthier J, Chassard D, Gelas P, Guiraud M, Bouletreau P
Département d'Anesthésie-Réanimation, Hôtel-Dieu, Lyon.
Ann Fr Anesth Reanim. 1992;11(2):205-8. doi: 10.1016/s0750-7658(05)80014-0.
Two cases of adult respiratory distress syndrome due to diffuse pulmonary haemorrhage are reported. The first patient was treated with azathioprine, prednisolone, cyclosporine and ranitidine for haemorrhagic rectocolitis; the second has untreated primary biliary cirrhosis. Haemoptysis only occurred in the latter. Both had severe isolated hypoxaemia. Chest X-rays revealed bilateral alveolar infiltrates. Bronchoscopies showed a diffusely bleeding bronchial tree. Both patients recovered after having been mechanically ventilated with positive end-expiratory pressure for six and eight days respectively. The cause of the diffuse pulmonary haemorrhage was, in the first case, severe thrombocytopaenia (17,000 G.1-1) of central origin, and, in the other patient, an unspecified vasculitis. Diffuse pulmonary haemorrhage should be added to the list of possible causes of the adult respiratory distress syndrome.
报告了两例因弥漫性肺出血导致的成人呼吸窘迫综合征。首例患者因出血性直肠结肠炎接受硫唑嘌呤、泼尼松龙、环孢素和雷尼替丁治疗；第二例患有未经治疗的原发性胆汁性肝硬化。咯血仅发生在后者。两人均有严重的单纯性低氧血症。胸部X线显示双侧肺泡浸润。支气管镜检查显示支气管树弥漫性出血。两名患者分别接受呼气末正压机械通气6天和8天后均康复。第一例弥漫性肺出血的原因是中枢性严重血小板减少（17,000 G.1-1），另一例患者的原因是未明确的血管炎。弥漫性肺出血应列入成人呼吸窘迫综合征可能的病因清单。
