Laursen Christian B, Davidsen Jesper Rømhild, Madsen Poul Henning
Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark.
BMJ Case Rep. 2012 Jun 21;2012:bcr0120125687. doi: 10.1136/bcr.01.2012.5687.
Drowning and near-drowning are common causes of accidental death worldwide and respiratory complications such as non-cardiogenic pulmonary oedema, acute respiratory distress syndrome and pneumonia are often seen. In other settings lung ultrasound can accurately diagnose these conditions; hence lung ultrasound may have a potential role in the evaluation of drowning or near-drowning victims. In this case report the authors describe a 71-year-old man who was brought to hospital with acute respiratory failure after a near-drowning accident. Lung ultrasound showed multiple B-lines on the anterior and lateral surfaces of both lungs, consistent with pulmonary oedema. Focus assessed transthoracic echocardiography showed no pericardial effusion and a normal global left ventricular function. Based on these findings the patient was diagnosed as having non-cardiogenic pulmonary oedema. Subsequent chest x-ray showed bilateral infiltrates consistent with pulmonary oedema. The case report emphasises the clinical value of lung ultrasound in the evaluation of a near-drowning victim.
溺水和近乎溺水是全球意外死亡的常见原因，常可见到诸如非心源性肺水肿、急性呼吸窘迫综合征和肺炎等呼吸并发症。在其他情况下，肺部超声能够准确诊断这些病症；因此，肺部超声在评估溺水或近乎溺水受害者方面可能具有潜在作用。在本病例报告中，作者描述了一名71岁男性，他在近乎溺水事故后因急性呼吸衰竭被送往医院。肺部超声显示双肺前表面和侧表面有多个B线，符合肺水肿表现。重点评估的经胸超声心动图显示无心包积液且左心室整体功能正常。基于这些发现，该患者被诊断为非心源性肺水肿。随后的胸部X光显示双侧浸润，符合肺水肿表现。该病例报告强调了肺部超声在评估近乎溺水受害者中的临床价值。
