Garner Orlando, Nunna Krishidhar, Braun Andrea
Baylor College of Medicine, Houston, TX, USA.
Case Rep Med. 2022 Apr 23;2022:8241057. doi: 10.1155/2022/8241057. eCollection 2022.
A 71-year-old man who was recently hospitalized for COVID-19 pneumonia complicated by acute hypoxemic respiratory failure and severe ARDS requiring noninvasive ventilation was transferred to our hospital from a rehabilitation facility for new onset right wrist and hand pain and swelling which had been attributed to arterial thrombosis and empirically treated with therapeutic anticoagulation. He developed numbness and paralysis in his right hand and was diagnosed with right forearm compartment syndrome requiring emergent fasciotomy. After a prolonged hospital stay complicated by respiratory failure requiring mechanical ventilation, he was discharged with improved, but not resolved, sensorimotor deficits. Arterial blood gas sampling is commonly performed in patients with acute hypoxemic respiratory failure, for assessment of oxygenation and acid-base status. It is considered a benign procedure, but it can lead to serious complications, such as bleeding and compartment syndrome. Risks and benefits of any procedure need to be weighed carefully and less is often more. Compartment syndrome is characterized by the 5 P's-pain, pallor, paresthesia, pulselessness, and paralysis.
一名71岁男性，近期因新型冠状病毒肺炎住院，并发急性低氧性呼吸衰竭和严重急性呼吸窘迫综合征，需要无创通气，后从康复机构转至我院，因新发右腕部及手部疼痛和肿胀，最初归因于动脉血栓形成，并接受了抗凝治疗。他出现右手麻木和麻痹，被诊断为右前臂骨筋膜室综合征，需要紧急行筋膜切开术。经过长时间住院，并发呼吸衰竭需要机械通气，出院时感觉运动功能缺损有所改善但未完全恢复。急性低氧性呼吸衰竭患者常进行动脉血气采样，以评估氧合和酸碱状态。这被认为是一种良性操作，但可能导致严重并发症，如出血和骨筋膜室综合征。任何操作的风险和益处都需要仔细权衡，通常少即是多。骨筋膜室综合征的特征为“5P”征——疼痛、苍白、感觉异常、无脉和麻痹。
