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一例需要体外膜肺氧合支持的糖尿病酮症酸中毒患者并发急性呼吸窘迫综合征。

Acute respiratory distress syndrome in a case of diabetic ketoacidosis requiring ECMO support.

作者信息

Darrat Milad, Gilmartin Brian, Kennedy Carmel, Smith Diarmuid

机构信息

Department of Endocrinology and Diabetes, Beaumont Hospital, Dublin, Ireland.

School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.

出版信息

Endocrinol Diabetes Metab Case Rep. 2021 Jul 1;2021. doi: 10.1530/EDM-20-0192.

Abstract

SUMMARY

Acute respiratory distress syndrome (ARDS) is a rare but life-threatening complication of diabetic ketoacidosis (DKA). We present the case of a young female, with no previous diagnosis of diabetes, presenting in DKA complicated by ARDS requiring extra corporeal membrane oxygenation (ECMO) ventilator support. This case report highlights the importance of early recognition of respiratory complications of severe DKA and their appropriate management.

LEARNING POINTS

ARDS is a very rare but life-threatening complication in DKA. The incidence of ARDS remains unknown but less frequent than cerebral oedema in DKA. The mechanism of ARDS in DKA has multifactorial aetiology, including genetic predisposition. Early recognition and consideration of rare pulmonary complication of DKA can increase survival rate and provide very satisfactory outcomes. DKA patients who present with refractory ARDS can be successfully rescued by ECMO support.

摘要

摘要

急性呼吸窘迫综合征(ARDS)是糖尿病酮症酸中毒(DKA)一种罕见但危及生命的并发症。我们报告了一例年轻女性病例,该患者既往无糖尿病诊断,此次因DKA合并ARDS就诊,需要体外膜肺氧合(ECMO)呼吸机支持。本病例报告强调了早期识别严重DKA呼吸并发症及其恰当处理的重要性。

学习要点

ARDS是DKA中一种非常罕见但危及生命的并发症。ARDS的发病率尚不清楚,但比DKA中的脑水肿少见。DKA中ARDS的机制有多种病因,包括遗传易感性。早期识别并考虑DKA罕见的肺部并发症可提高生存率并带来非常满意的结果。出现难治性ARDS的DKA患者可通过ECMO支持成功救治。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3222/8284957/43baa9f08a67/EDM20-0192fig1.jpg

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