Nguyen Thanh T, Hussain Elora, Grimason Michele, Goldstein Joshua, Wainwright Mark S
1Ruth D. and Ken M. Davee Pediatric Neurocritical Care Program, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
J Child Neurol. 2013 Oct;28(10):1287-91. doi: 10.1177/0883073812453871. Epub 2012 Aug 16.
Neurogenic pulmonary edema is a clinical syndrome that manifests as an acute onset of pulmonary edema in the setting of a central nervous system injury, without cardiac dysfunction. Neurogenic pulmonary edema is rare in children, and the mechanism is still not completely understood. The clinical pathology overlaps with acute lung injury and acute respiratory distress syndrome. The authors report a case of a 14-month-old previously healthy child who presented with febrile status epilepticus, fulminant neurogenic pulmonary edema, and acute respiratory distress syndrome. Neurogenic pulmonary edema should be considered in the differential diagnosis for the rapid progression of respiratory failure following an acute neurological injury such as status epilepticus in a child. Prompt respiratory support and treatment of the acute neurological insult can prevent further cerebral hypoxemic injury.
神经源性肺水肿是一种临床综合征,表现为在中枢神经系统损伤情况下急性发作的肺水肿,且无心脏功能障碍。神经源性肺水肿在儿童中较为罕见,其发病机制仍未完全明确。临床病理与急性肺损伤和急性呼吸窘迫综合征重叠。作者报告了一例14个月大的既往健康儿童,该患儿出现发热性癫痫持续状态、暴发性神经源性肺水肿和急性呼吸窘迫综合征。对于儿童急性神经损伤(如癫痫持续状态)后呼吸衰竭迅速进展的情况,鉴别诊断时应考虑神经源性肺水肿。及时的呼吸支持和对急性神经损伤的治疗可预防进一步的脑缺氧损伤。