Neonatal and Pediatric Intensive Care Services, 468688Surya Mother and Child Care Superspecialty Hospital, Pune, India.
Trop Doct. 2022 Oct;52(4):607-609. doi: 10.1177/00494755221114327. Epub 2022 Aug 9.
A late preterm presented with multisystem involvement (respiratory failure, shock, acute kidney injury). Initially, the baby was managed with mechanical ventilation, inotropic support, antibiotics, fluid restriction and furosemide infusion. Despite conservative management for 12 h, urine output, metabolic status and renal function did not improve; peritoneal dialysis was therefore commenced. Intravenous immunoglobulin and methylprednisolone were introduced. Respiratory failure, shock and acute kidney injury (AKI) then resolved. The baby's condition gradually improved, and he was discharged after 19 days. On follow up, he was gaining weight satisfactorily, with no sequalae. Atypical presentation of multisystem involvement in the form of AKI should not be missed since it is treatable with definitive and supportive care and has a favorable outcome.
一例晚期早产儿表现为多系统受累（呼吸衰竭、休克、急性肾损伤）。最初，婴儿接受了机械通气、正性肌力支持、抗生素、液体限制和呋塞米输注治疗。尽管保守治疗 12 小时，但尿量、代谢状态和肾功能均无改善；因此开始进行腹膜透析。静脉注射免疫球蛋白和甲基强的松龙也被使用。呼吸衰竭、休克和急性肾损伤（AKI）随后得到解决。婴儿的病情逐渐好转，19 天后出院。随访时，他的体重增加令人满意，没有后遗症。多系统受累的不典型表现形式为 AKI 不应被忽视，因为它可以通过明确和支持性治疗来治疗，并且有良好的预后。
