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Rapid Resolution of Acute Hypoxemic Respiratory Failure in a Perioperative Patient

手術期間急性缺氧的呼吸衰竭得到快速消除-病例報告

摘要


我們報告一位12 歲的女孩在接受由全身麻醉進行的扁桃腺切例行手術。這吸入事件發生在麻醉誘導時,氣管內管插入前。呼吸窘迫及低血氧濃度立即發生。緊急處理包括在手術室內進行抽吸呼吸道,氣管內管置入,及支氣管鏡檢查。事件發生三小時後,胸部X 光片上不正常處消失,臨床情況也改善。再過一小時後,病人脫離呼吸器並拔氣管內管。事件發生六日後,病人出院,沒有任何可察覺到的後遺症。這與文獻論述及一般認知不同。我們在此報告這不尋常的情況,及支氣管鏡在治療胃酸吸入肺事件的角色。

並列摘要


We reported the case of a 12-year-old girl who was scheduled for elective tonsillectomy under general anesthesia. An aspiration episode occurred during the induction of anesthesia prior to tracheal intubation. Respiratory distress with hypoxemia developed rapidly. Emergency interventions including respiratory tract suctioning, tracheal intubation and bronchoscopy were performed in the operating room. Three hours after presentation, the radiological abnormalities resolved, and the clinical features improved as well. She was weaned from the ventilator during the following 1 hour. Six days after the episode, she was discharged from the hospital without detectable sequelae. The brief course of her respiratory distress differed from that reported previously. We describe this uncommon event and discuss the role of bronchoscopy in a gastric acid aspiration episode such as this.

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