大津户导致的严重急性呼吸窘迫综合征。
Severe acute respiratory distress syndrome caused by Otsujito.
作者信息
Hirasawa Nobuhisa, Nakae Hajime, Satoh Kasumi, Yoshida Kenji, Okuyama Manabu
机构信息
Department of Emergency and Critical Care Medicine Akita University Graduate School of Medicine Akita Japan.
出版信息
Acute Med Surg. 2023 Jul 17;10(1):e874. doi: 10.1002/ams2.874. eCollection 2023 Jan-Dec.
BACKGROUND
Kampo prescriptions can cause drug-induced lung injury (DLI) and acute respiratory distress syndrome (ARDS). However, severe respiratory failure induced by Otsujito (OJT) is extremely rare. High-dose steroid pulse therapy is generally given to patients with severe DLI.
CASE PRESENTATION
A 63-year-old man with respiratory distress was admitted to our hospital. The patient was diagnosed with severe ARDS caused by OJT, which had been prescribed 4 weeks prior to admission. Thus, OJT was discontinued, and intensive care for ARDS, including ventilation and prone positioning, was implemented. His respiratory condition rapidly improved after treatment with an initial methylprednisolone dose (1.5 mg/kg/day). He was extubated on day 4 and discharged on day 16. The steroid dose was gradually reduced and discontinued by day 116.
CONCLUSION
A severe case of ARDS caused by OJT was successfully treated with low-dose steroids and specialized intensive care.
背景
汉方制剂可导致药物性肺损伤（DLI）和急性呼吸窘迫综合征（ARDS）。然而，大建中汤（OJT）诱发的严重呼吸衰竭极为罕见。对于严重的DLI患者，通常给予大剂量类固醇冲击疗法。
病例报告
一名63岁呼吸窘迫男性入住我院。该患者被诊断为由入院前4周开具的OJT引起的严重ARDS。因此，停用OJT，并对ARDS进行了包括通气和俯卧位在内的重症监护。在给予初始剂量的甲泼尼龙（1.5mg/kg/天）治疗后，他的呼吸状况迅速改善。他于第4天拔管，并于第16天出院。类固醇剂量逐渐减少，并在第116天停药。
结论
一例由OJT引起的严重ARDS病例通过低剂量类固醇和专业重症监护成功治愈。
Zotero 插件