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ISSN 1810-2352 (Print)

2021, Number 3

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Rev Cub Med Int Emerg 2021; 20 (3)

Severe acute respiratory distress syndrome associated with bronchopleurocutaneous fistula

Uriarte MAE, Pérez PE, Fernández GA, García HB

Language: Spanish
References: 10
Page: 1-11
PDF size: 218.64 Kb.


ABSTRACT

Introduction: Acute respiratory distress syndrome (ARDS) is the clinical expression of severe pulmonary edema of non-cardiogenic origin. It is a disease with significant mortality of around 20% - 50%, according to different studies. The care of a patient with ARDS and bronchopleurocutaneous fistula and survival after such severe and sustained hypoxemia are uncommon.
Objective: To describe the treatment and evolution of a patient with acute respiratory distress syndrome associated with bronchopleurocutaneous fistula.
Clinical report: We report the case of a one-year-old girl who, from an extensive right pneumonia, complicated with septate empyema and bronchopleurocutaneous fistula developed a very serious ARDS. She was successfully treated. Radiograph Images shown and the unusualness of this clinical evolution is discussed.
Conclusions: Permissive hypoxemia in some patients could be lower than what is reported in the literature. Never before has such a critical case of hypoxemia been seen to have survived. The decision to treat conservatively bronchopleurocutaneous fistula in a critically ill patient on mechanical ventilation appears to be an appropriate approach, if acceptable oxygenation parameters are achieved.


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