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一名患有严重哮喘持续状态伴呼吸衰竭、气胸及复杂临床病程的年轻成人因气压伤继发视乳头水肿

Papilledema Secondary to Barotrauma in a Young Adult With Severe Status Asthmaticus With Ventilatory Failure, Pneumothorax, and a Complex Clinical Course.

作者信息

Idries Iyad Y, Khristoforov Vasilii, Yadav Ruchi, Sur Avtar, Yadav Vivek, Hossny Ahmed, Kalambay Junior, Zaman Mohammad

机构信息

Internal Medicine, Brookdale University Hospital Medical Center, Brooklyn, USA.

Intensive Care Unit, Brookdale University Hospital Medical Center, Brooklyn, USA.

出版信息

Cureus. 2023 Dec 6;15(12):e50044. doi: 10.7759/cureus.50044. eCollection 2023 Dec.

Abstract

Intubation and mechanical ventilation are common therapeutic interventions in intensive care unit settings. Barotrauma is a known complication of using positive pressures in a tissue defined by extra alveolar air in locations where it is not generally found in patients receiving mechanical ventilation. Several clinical manifestations of barotrauma include pneumothorax, subcutaneous emphysema, pneumoperitoneum, pneumomediastinum or pneumopericardium, air embolization, and hyperinflated left lower lobe. However, papilledema is an unreported and uncommon complication we observed in one of our patients, making it a unique presentation. We present the case of a young male patient intubated for asthma exacerbation requiring mechanical ventilation with subsequent development of papilledema. Our case report highlights the importance of knowing this rare complication of barotrauma as early commencement of lung-protective strategies will help prevent it.

摘要

气管插管和机械通气是重症监护病房常见的治疗手段。气压伤是在机械通气患者通常不存在肺泡外气体的组织中使用正压通气时已知的并发症。气压伤的几种临床表现包括气胸、皮下气肿、气腹、纵隔气肿或心包积气、空气栓塞以及左肺下叶过度膨胀。然而,视乳头水肿是我们在一名患者中观察到的未报告且不常见的并发症,使其成为一种独特的表现。我们报告一例因哮喘急性加重行气管插管并需要机械通气的年轻男性患者,随后出现视乳头水肿。我们的病例报告强调了了解这种罕见的气压伤并发症的重要性,因为尽早开始肺保护策略将有助于预防它。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da97/10768707/6ba0b2880a10/cureus-0015-00000050044-i01.jpg

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