使用肺泡回復術於急性呼吸窘迫症病人：個案報告

Lung Recruitment Maneuver in a Ventilated Patient with Acute Respiratory Distress Syndrome: A Case Report

余佳秀(Chia-Siou Yu) ； 周芝菊(Chih-Chu Chou) ； 劉惠嬌(Hui-Chiao Liu) ； 陳雪莉(Hsueh-Li Chen) ； 柯延昆(Yen-Kun Ko)

《輔仁醫學期刊》 10卷2期 (2012/06) Pp. 101-106

摘要

急性呼吸窘迫症（ARDS）用肺泡回復術可改善氧合，但臨床使用仍有爭論。本案係探討一位肺炎病人合併嚴重低血氧的呼吸照護過程，個案因肺炎合併急性呼吸衰竭使用呼吸器，於加護病房期間持續惡化出現嚴重低血氧，藥物治療未改善。故使用七次肺泡回復術（Lung Recruitment Maneuver）以維持血氧濃度，每次執行後呼吸器潮氣容積與肺順應性皆增加，治療期間肺塌陷與血氧濃度亦改善。個案漸脫離呼吸器，出院後於居家照護僅晚上使用呼吸器。藉本案認識嚴重低血氧的呼吸照護策略。

關鍵字

急性呼吸窘迫症 ； 低血氧 ； 肺泡回復術 ； 急性肺損傷

並列摘要

In patients with acute respiratory distress syndrome (ARDS), the use of lung-recruitment maneuvers to improve oxygenation is still controversial. This case report examines the course of respiratory care in a ventilated pneumonia patient with severe hypoxemia. The clinical condition of the patient deteriorated under antibiotic treatment in the intensive care unit. A lung recruitment maneuver was performed 7 times to improve oxygenation. The tidal volume and dynamic lung compliance increased after the lung recruitment maneuver, and the situation of lung collapse and saturation gradually improved during the treatment period. The weaning process was extended in this patient by using the ventilator at night after being discharged. We can learn about respiratory care with severe hypoxemia from this case.

並列關鍵字

acute respiratory distress syndrome ； hypoxemia ； lung recruitment maneuver ； acute lung injury