• 제목/요약/키워드: acute respiratory distress syndrome

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A Case of Acute Fulminant Fat Embolism Syndrome after Liposuction Surgery

  • Byeon, Seong Wook;Ban, Tae Hyun;Rhee, Chin Kook
    • Tuberculosis and Respiratory Diseases
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    • 제78권4호
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    • pp.423-427
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    • 2015
  • Fat embolism syndrome (FES) is a clinical manifestation that consists of multiple organ dysfunction due to fat emboli. FES occurs as a complication after trauma or procedures such as surgery. The diagnostic criteria of FES have not yet been established, so clinical criteria are used for its diagnosis. The clinical course of acute fulminant FES can be rapid. Liposuction surgery, in which adipocytes are mechanically disrupted, is one cause of FES. As the number of liposuction surgeries increases, clinicians should be aware of the possibility of FES. This was the first report of a case of acute fulminant FES with severe acute respiratory distress syndrome after liposuction surgery, in Korea.

외상성 폐손상시 체외막형 산화기 치료 - 2 예 - (Extracorporeal Membrane Oxygenation Treatment of Traumatic Lung Injury - 2 cases -)

  • 양진성;신화균;허균;원용순
    • Journal of Trauma and Injury
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    • 제24권2호
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    • pp.155-158
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    • 2011
  • Mechanical ventilation is usually the treatment of choice for severe respiratory failure associated with trauma. However, in case of severe hypoxia, mechanical ventilation may not be sufficient for gas exchange in lungs. Patients with Acute Respiratory Distress Syndrome (ARDS) undergo difficulties in oxygen and carbon dioxide exchange. Extracorporeal Membrane Oxygenation (ECMO) is the ideal therapeutic option for those patients with severe traumatic injuries. ECMO allows lungs to reserve their functions and decreases further lung injuries while increasing survival rate at the same time. We report two cases of patients with traumatic ARDS and Multiple Organ Failure including compromised heart function. The preservation of lung function was successful using ECMO therapy.

ATRA로 유발된 급성호흡곤란증후군 1예 (A Case of Acute Respiratory Distress Syndrome Induced by All-Trans-Retinoic Acid)

  • 김철;고원기;권승현;강신명;김창년;양동규;김세규;장준;김성규;이원영;양우익
    • Tuberculosis and Respiratory Diseases
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    • 제49권1호
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    • pp.93-98
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    • 2000
  • Acute respiratory distress syndrome (ARDS) has been reported to be associated with a variety of medical and surgical conditions, including All-trans-retinoic acid (ATTA). ATRA is very efficaceous drug to acute promyelocytic leukemia (APL). This drug can induce complete remission at APL without fatal risk of disseminated intravascular coagulation. But ATRA treatment, sometimes, produces the symptoms of fever, weight gain and acute respiratory distress, renal function impairment. The causes of these symptoms are not fully proved, but supposed as the result of leukostasis and capillary leak syndrome from excessive leukocyte differentiation and cytokines release. Recently, we experienced a 24-year-old woman who complained gum bleeding for 6 days. At bone marrow biopsy, she was diagnosed as APL. 2 days after ATRA treatment, she was suffered from the symptoms of dyspnea and general ache. At laboratory examination, total leukocyte count was 50,400/$mm^3$, $PaO_2$ was 42.5 mm Hg and chest PA revealed the findings compatible with ARDS. Treatment with low dose ara-C, corticosteroid and general supportive cares were tried. Within 3 days after treatment, the patient recovered from ARDS by evidence of arterial blood gas study and chest radiographs. She has acquired complete remission of APL with maintenance of A TRA. And so, we present this case with a review of related literatures.

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체외생명보조를 이용한 중증 급성호흡곤란증후군 치료 1예 (A Case of Severe Acute Respiratory Distress Syndrome Treated with Extracorporeal Life Support)

  • 김영묵;이주용;이명구;이창률;김고운;손경민;양하나;김대용;최현희;김형수
    • Tuberculosis and Respiratory Diseases
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    • 제63권6호
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    • pp.526-530
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    • 2007
  • 중증급성호흡곤란증후군으로 전원 된 41세 여자환자를 기존의 기계환기 방법으로 치료했으나 저산소증이 호전되지 않아 내원 후 3시간 내에 신속한 체외생명보조를 시행하여 성공적으로 치료한 예를 경험하여 문헌고찰과 함께 보고하는 바이다.

Clinical Impact of Supplementation of Vitamins B1 and C on Patients with Sepsis-Related Acute Respiratory Distress Syndrome

  • Yoo, Jung-Wan;Kim, Rock Bum;Ju, Sunmi;Lee, Seung Jun;Cho, Yu Ji;Jeong, Yi Yeong;Lee, Jong Deog;Kim, Ho Cheol
    • Tuberculosis and Respiratory Diseases
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    • 제83권3호
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    • pp.248-254
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    • 2020
  • Background: Although few studies have reported improved clinical outcomes with the administration of vitamin B1 and C in critically ill patients with septic shock or severe pneumonia, its clinical impact on patients with sepsis-related acute respiratory distress syndrome (ARDS) remains unclear. The purpose of this study was to evaluate the association with vitamin B and C supplementation and clinical outcomes in patients with ARDS. Methods: Patients with ARDS requiring invasive mechanical ventilation, admitted to the medical intensive care unit (ICU) were included in this study. Clinical outcomes were compared between patients administered with vitamin B1 (200 mg/day) and C (2 g/day) June 2018-May 2019 (the supplementation group) and those who did not receive vitamin B1 and C administration June 2017-May 2018 (the control group). Results: Seventy-nine patients were included. Thirty-three patients received vitamin B1 and C whereas 46 patients did not. Steroid administration was more frequent in patients receiving vitamin B1 and C supplementation than in those without it. There were no significant differences in the mortality between the patients who received vitamin B1 and C and those who did not. There were not significant differences in ventilator and ICU-free days between each of the 21 matched patients. Conclusion: Vitamin B1 and C supplementation was not associated with reduced mortality rates, and ventilator and ICU-free days in patients with sepsis-related ARDS requiring invasive mechanical ventilation.

The Utility of Non-Invasive Nasal Positive Pressure Ventilation for Acute Respiratory Distress Syndrome in Near Drowning Patients

  • Kim, June Hyeong;Sun, Kyung Hoon;Park, Yong Jin
    • Journal of Trauma and Injury
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    • 제32권3호
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    • pp.136-142
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    • 2019
  • Purpose: Near drowning refers to immediate survival after asphyxia due to submersion or immersion in water, which is a crucial public safety problem worldwide. Acute lung injury or acute respiratory distress syndrome (ARDS) is a common complication of near drowning. The purpose of this study was to investigate the feasibility and effectiveness of noninvasive nasal positive pressure ventilation (NINPPV). Methods: This retrospective study was conducted at a tertiary emergency department. NINPPV was administered for moderate ARDS caused by submersion or immersion in patients who were older than 18 years, from January 2015 to December 2018. We collected the demographic (age, sex, length of hospital stay, and outcome), laboratory (arterial blood gas, lactate, oxygen saturation, partial pressure of oxygen divided by the fraction of inspired oxygen, complete blood count, blood urea nitrogen, and creatinine), and clinical data (acute lung injury index and ventilator failure) of the patients. A statistical analysis was performed using Statistical Package for the Social Sciences version 20.0 for Windows. Results: NINPPV treatment was provided to 57 patients for near drowning, 45 of whom (78.9%) were successfully treated without complications; in 12 (21.1%), treatment was changed to invasive mechanical ventilation within 48 hours due to ARDS or acute kidney injury. NINPPV treatment was successful in 31 (75.6%) out of 41 sea-water near drowning patients. They were more difficult to treat with NINPPV compared with the fresh-water near drowning patients (p<0.05). Conclusions: NINPPV would be useful and feasible as the initial treatment of moderate ARDS caused by near drowning.

소세포폐암 환자에서 토포테칸 투약 후 발생한 급성호흡곤란증후군 (Acute Respiratory Distress Syndrome after Topotecan Therapy in a Patient with Small Cell Lung Cancer)

  • 태정현;이진화;김윤경;심윤수;이경종;노영욱;박재정;류연주;천은미;장중현
    • Tuberculosis and Respiratory Diseases
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    • 제65권2호
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    • pp.142-146
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    • 2008
  • 소세포폐암은 비교적 초기 항암치료에 대한 반응이 우수하지만 빠르게 진행하는 것으로 알려져 있다. Topotecan은 topoisomerase I inhibitor로 소세포폐암에서 이차치료제로 사용된다. Topotecan의 흔한 부작용으로는 빈혈, 혈소판감소증, 호중구감소증과 같은 혈액학적 부작용이 있으나, topotecan에 의한 폐독성은 잘 알려져 있지 않다. 저자들은 일차치료에 불응하여 이차치료제로 topotecan을 투여 받던 소세포폐암 환자에서 3주기 topotecan 투약중에 발생한 급성호흡곤란증후군을 경험하여 보고한다. 환자는 호흡곤란을 호소하면서 호흡부전에 빠졌으며, 흉부전산화단층촬영에서 약제에 의한 폐손상을 시사하는 미만성 간유리음영을 보였다. 환자는 급성호흡곤란증후군으로 사망하였다.

Characteristics and Outcomes of Patients with Pulmonary Acute Respiratory Distress Syndrome Infected with Influenza versus Other Respiratory Viruses

  • Yoo, Jung-Wan;Ju, Sunmi;Lee, Seung Jun;Cho, Min-Chul;Cho, Yu Ji;Jeong, Yi Yeong;Lee, Jong Deog;Kim, Ho Choel
    • Tuberculosis and Respiratory Diseases
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    • 제82권4호
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    • pp.328-334
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    • 2019
  • Background: Although the frequency of respiratory viral infection in patients with pulmonary acute respiratory distress syndrome (ARDS) is not uncommon, clinical significance of the condition remains to be further elucidated. The purpose of this study was to compare characteristics and outcomes of patients with pulmonary ARDS infected with influenza and other respiratory viruses. Methods: Clinical data of patients with pulmonary ARDS infected with respiratory viruses January 2014-June 2018 were reviewed. Respiratory viral infection was identified by multiplex reverse transcription-polymerase chain reaction (RT-PCR). Results: Among 126 patients who underwent multiplex RT-PCR, respiratory viral infection was identified in 46% (58/126): 28 patients with influenza and 30 patients with other respiratory viruses. There was no significant difference in baseline and clinical characteristics between patients with influenza and those with other respiratory viruses. The use of extracorporeal membrane oxygenation (ECMO) was more frequent in patients with influenza than in those with other respiratory viruses (32.1% vs 3.3%, p=0.006). Co-bacterial pathogens were more frequently isolated from respiratory samples of patients with pulmonary ARDS infected with influenza virus than those with other respiratory viruses. (53.6% vs 26.7%, p=0.036). There were no significant differences regarding clinical outcomes. In multivariate analysis, acute physiology and chronic health evaluation II was associated with 30-mortality (odds ratio, 1.158; 95% confidence interval, 1.022-1.312; p=0.022). Conclusion: Respiratory viral infection was not uncommon in patients with pulmonary ARDS. Influenza virus was most commonly identified and was associated with more co-bacterial infection and ECMO therapy.