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医学重症监护病房中对负压性肺水肿的认识

The Awareness of Negative Pressure Pulmonary Edema in the Medical Intensive Care Unit.

作者信息

Zhang Qian, Vayalumkal Jonathan, Ricely John, Elrod Sarah, Raza Ahmad

机构信息

Internal Medicine, Abington Hospital-Jefferson Health, Abington, USA.

出版信息

Cureus. 2020 Sep 4;12(9):e10251. doi: 10.7759/cureus.10251.

Abstract

Negative pressure pulmonary edema (NPPE) is a noncardiogenic-related rapid onset of bilateral pulmonary edema secondary to various etiologies that lead to upper airway obstruction. Despite the fact that it is more commonly seen in the emergency department (ED), pediatric intensive care unit (PICU), and the postanesthesia care unit (PACU), there is a lower disease prevalence in the medical intensive care unit (MICU) as it sometimes could be overlooked upon. Prompt treatment often leads to favorable clinical outcomes. We detail a 55-year-old lady with a past medical history of nephrolithiasis, obesity, and obstructive sleep apnea presented with right flank pain due to right kidney subcapsular hematoma and left hydronephrosis due to distal ureteral calculus requiring urological intervention. She unfortunately subsequently developed NPPE requiring MICU level of care after reintubation. Successful extubation was achieved two days later as timely recognition of NPPE led to proper treatment. She was downgraded to general medicine service and discharged without complications.

摘要

负压性肺水肿(NPPE)是一种与非心源性相关的双侧肺水肿,起病迅速,继发于各种导致上呼吸道梗阻的病因。尽管它在急诊科(ED)、儿科重症监护病房(PICU)和麻醉后监护病房(PACU)更为常见,但在医学重症监护病房(MICU)的疾病患病率较低,因为它有时可能被忽视。及时治疗通常会带来良好的临床结果。我们详细介绍一位55岁女性,她有肾结石、肥胖和阻塞性睡眠呼吸暂停的既往病史,因右肾包膜下血肿出现右侧胁腹疼痛,因远端输尿管结石导致左肾积水,需要泌尿外科干预。不幸的是,她在重新插管后随后发展为需要MICU护理水平的NPPE。由于及时识别NPPE并进行了适当治疗,两天后成功拔管。她被降级到普通内科病房,出院时没有并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbe8/7536111/bcb0c5295413/cureus-0012-00000010251-i01.jpg

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