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意外近乎缢死所致的梗阻后肺水肿

Postobstructive pulmonary edema following accidental near-hanging.

作者信息

Berdai Adnane Mohamed, Labib Smael, Harandou Mustapha

机构信息

Pediatric Intensive Care Unit, University Hospital Hassan II, Fes, Morocco.

出版信息

Am J Case Rep. 2013 Sep 6;14:350-3. doi: 10.12659/AJCR.889415. eCollection 2013.

Abstract

PATIENT

Female, 14 FINAL DIAGNOSIS: Postobstructive pulmonary edenma Symptoms: Chest indrawing • bilateral pulmonary crepitations • tachypnea

MEDICATION

  • Clinical Procedure: Controlled ventilatory support • positive end expiratory pressure Specialty: Intensive care.

OBJECTIVE

Unusual clinical course.

BACKGROUND

Postobstructive pulmonary edema (POPE) is a life-threatening complication that occurs after the relief of an upper airway obstruction. POPE occurs rarely in children, primarily after non-lethal hanging.

CASE REPORT

We report the case of a 14-year-old girl who developed POPE after accidental near hanging. She had chest in-drawing, the SpO2 was 81% on room air, and pulmonary auscultation revealed bilateral crepitations. The chest x-ray showed bilateral diffuse infiltrates consistent with pulmonary edema. The intensive care management consisted of controlled ventilatory support with high-level positive end expiratory pressure. On the third day of hospitalization, the patient was weaned from the ventilator and extubated with a full recovery.

CONCLUSIONS

This case confirms the importance of early recognition of POPE and the value of adapted treatment, which can lead to a favorable outcome and full recovery in cases of near hanging.

摘要

患者

女性,14岁 最终诊断:梗阻后肺水肿 症状:胸廓凹陷 • 双侧肺部啰音 • 呼吸急促

用药情况

  • 临床操作:控制性通气支持 • 呼气末正压 专科:重症监护

目的

不寻常的临床病程

背景

梗阻后肺水肿(POPE)是上呼吸道梗阻解除后发生的一种危及生命的并发症。POPE在儿童中很少见,主要发生在非致命性上吊后。

病例报告

我们报告一例14岁女孩在意外近上吊后发生POPE的病例。她有胸廓凹陷,空气中血氧饱和度为81%,肺部听诊显示双侧啰音。胸部X线显示双侧弥漫性浸润,符合肺水肿表现。重症监护管理包括采用高水平呼气末正压的控制性通气支持。住院第三天,患者脱机并拔管,完全康复。

结论

该病例证实了早期识别POPE的重要性以及适当治疗的价值,这可使近上吊病例获得良好结局并完全康复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/248f/3767585/b10b799980cd/amjcaserep-14-350-g001.jpg

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