Gu C H, Li X M, Kang X W
Department of Critical Care Medicine, the First People's Hospital of Lianyungang City, Lianyungang 222002, China.
Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2023 Dec 20;39(12):1185-1189. doi: 10.3760/cma.j.cn501225-20230818-00052.
A 54-year-old male patient with severe acute respiratory distress syndrome caused by inhalation injury was admitted to the First People's Hospital of Lianyungang City on June 26, 2022. After admission, the patient received invasive mechanical ventilation (driving pressure-guided ventilator parameter setting) combined with prone position treatment immediately, but his condition continued to deteriorate. Five hours after admission, the patient received veno-venous extracorporeal membrane oxygenation (VV-ECMO) supporting treatment, treatment based on ultra-protective lung ventilation strategy combined with prone position ventilation for more than 12 hours per day. At the same time, pulse contour cardiac output monitoring technology was used to monitor cardiac index and extravascular lung water index to guide volume management, and fiberoptic bronchoalveolar lavage was performed for several times. After that, the patient was successfully weaned from VV-ECMO and ventilator, and then discharged from hospital successfully. During follow-up of one year after the injury, the patient showed no obvious respiratory symptoms, and his lung function was basically normal.
一名54岁男性患者因吸入性损伤导致严重急性呼吸窘迫综合征,于2022年6月26日入住连云港市第一人民医院。入院后,患者立即接受有创机械通气(驱动压力引导的呼吸机参数设置)联合俯卧位治疗,但病情仍持续恶化。入院5小时后,患者接受静脉-静脉体外膜肺氧合(VV-ECMO)支持治疗,基于超保护性肺通气策略联合每天超过12小时的俯卧位通气进行治疗。同时,采用脉搏轮廓心输出量监测技术监测心脏指数和血管外肺水指数以指导容量管理,并多次进行纤维支气管镜肺泡灌洗。此后,患者成功撤掉VV-ECMO和呼吸机,随后顺利出院。在受伤后一年的随访中,患者无明显呼吸道症状,肺功能基本正常。