Metry Ayman Anis
Assistant Professor of Anesthesia, ICU and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Anesthesia and ICU Consultant, Kalba Hospital, MOHAP, Sharjah, UAE.
Int J Crit Illn Inj Sci. 2019 Apr-Jun;9(2):91-95. doi: 10.4103/IJCIIS.IJCIIS_83_18.
A 47-year-old patient presented to the emergency room with an attack of acute severe asthma. In spite of all primary measures, the patient was deteriorating. Arterial blood gases showed hypercarbia and acidemia. The patient was shifted to the intensive care unit connected to noninvasive ventilation for 3 h, without any obvious improvement. Decision was taken to intubate, ventilate, and keep her deeply sedated. On the 4 day of ventilation, the patient developed sudden tension pneumothorax and she was near to arrest. Management for tension pneumothorax was immediate and successful. After that, chest X-ray and computerized tomography scan showed hemopneumothorax, for which a chest tube was inserted in both chest sides and blood transfusion was initiated immediately. After this incidence, the patient's parameters improved dramatically. Four days later, the patient was extubated and kept in intensive care unit till the chest tubes were removed and then shifted to the ward and discharged on day 15 from admission.
一名47岁的患者因急性重症哮喘发作被送往急诊室。尽管采取了所有初步措施，患者病情仍在恶化。动脉血气显示高碳酸血症和酸血症。患者被转至重症监护病房，接受无创通气3小时，但无明显改善。决定进行气管插管、机械通气并使其深度镇静。在通气第4天，患者突然发生张力性气胸，濒临心跳骤停。对张力性气胸的处理迅速且成功。此后，胸部X线和计算机断层扫描显示血气胸，遂立即在双侧胸部插入胸管并开始输血。此次事件后，患者的各项指标显著改善。4天后，患者拔除气管插管，留在重症监护病房直至胸管拔除，然后转至病房，并于入院第15天出院。
