Lemaire F, Cerrina J, Lange F, Harf A, Carlet J, Bignon J
Chest. 1982 May;81(5):654-7. doi: 10.1378/chest.81.5.654.
This report describes a case of paraquat poisoning, treated with continuous positive airway pressure. After an initial phase of acute respiratory failure with diffuse pulmonary edema, we observed radiologically a complete clearing of both lungs, associated with an aspect of overdistension. Surprisingly, FRC was above normal, as was total quasi static compliance. The patient died on the 15th day, with intractable hypoxemia. Pathologic analysis revealed large zones of parenchyma with overdistended airspaces, explaining the emphysematous-like aspect of the lungs. We propose that the attempts to increase lung volume with CPAP, at an early phase of diffuse epithelial disorganization, may have, partially at least, dilated the remaining distal airspaces.
本报告描述了一例百草枯中毒病例，采用持续气道正压通气进行治疗。在出现伴有弥漫性肺水肿的急性呼吸衰竭初始阶段后，我们通过放射学观察到双肺完全清晰，伴有过度膨胀的表现。令人惊讶的是，功能残气量高于正常，总准静态顺应性也是如此。患者在第15天死于顽固性低氧血症。病理分析显示实质组织有大片气腔过度膨胀区域，解释了肺部类似肺气肿的表现。我们认为，在弥漫性上皮组织紊乱的早期阶段，试图通过持续气道正压通气增加肺容积，可能至少部分地扩张了剩余的远端气腔。
