Desachy A, Gissot V
Service de réanimation polyvalente, centre hospitalier d'Angoulême, Saint-Michel, France.
Ann Fr Anesth Reanim. 2006 Mar;25(3):299-301. doi: 10.1016/j.annfar.2005.09.010. Epub 2006 Jan 4.
A 34-year-old woman with toxic coma developed inhalation pneumonia complicated by the acute respiratory distress syndrome. Marked parenchymal destruction and recurrent pneumothorax occurred despite protective ventilation. Altered consciousness persisted after sedative withdrawal, and the patient subsequently died. Computed tomography revealed multiple cerebral, renal and splenic infarcts. The only identified cause of systemic embolism was multiple gas embolisms. We discuss the physiopathological mechanisms, and the diagnostic and therapeutic management of such patients.
一名34岁的中毒昏迷女性发生吸入性肺炎，并并发急性呼吸窘迫综合征。尽管采取了保护性通气措施，但仍出现了明显的实质破坏和反复气胸。停用镇静剂后意识仍未恢复，患者随后死亡。计算机断层扫描显示脑、肾和脾多处梗死。唯一确定的全身栓塞原因是多发性气体栓塞。我们讨论了此类患者的生理病理机制以及诊断和治疗管理。
