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Published in: European Journal of Medical Research 1/2020

Open Access 01-12-2020 | Pneumothorax | Case report

Successful treatment of severe pneumonia, pyopneumothorax with severe acute respiratory distress syndrome, and septic shock: a case report

Authors: Xi Wang, Jian Lan, Ruijie Zhang, Xiaoqing Luo

Published in: European Journal of Medical Research | Issue 1/2020

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Abstract

Background

This article reports a patient who survived severe pneumonia, pyopneumothorax with acute respiratory distress syndrome (ARDS), and septic shock, which is very difficult to treat.

Case presentation

Antibiotics, continuous renal replacement therapy (CRRT), bronchial lavage and other treatments were used to treat a patient with pneumonia, pyopneumothorax, severe ARDS and septic shock. After comprehensive treatment, the patient was successfully treated and survived for a long time.

Conclusions

There is a low successful clinical treatment rate for patients with pneumonia, pyopneumothorax with severe ARDS and septic shock. The successful treatment of this patient benefited from early and effective empirical therapy, targeted drug selection in the later stage, adequate closed thoracic drainage, repeated bronchial lavage, early CRRT, an appropriate respiratory support mode and parameter setting, immunotherapy and nutritional support therapy. This paper proposes a reference diagnosis and treatment solution for similar cases.
Literature
1.
go back to reference Bellani G. Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA. 2016;315(8):788–800. CrossRef Bellani G. Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA. 2016;315(8):788–800. CrossRef
2.
go back to reference Anzueto A. Incidence, risk factors and outcome of barotrauma in mechanically ventilated patients. Intens Care Med. 2004;30(4):612–9. CrossRef Anzueto A. Incidence, risk factors and outcome of barotrauma in mechanically ventilated patients. Intens Care Med. 2004;30(4):612–9. CrossRef
3.
go back to reference Sheu C. Clinical characteristics and outcomes of sepsis-related vs non-sepsis-related ARDS. Chest. 2010;138(3):559–67. CrossRef Sheu C. Clinical characteristics and outcomes of sepsis-related vs non-sepsis-related ARDS. Chest. 2010;138(3):559–67. CrossRef
4.
go back to reference Han F. Early initiation of continuous renal replacement therapy improves clinical outcomes in patients with acute respiratory distress syndrome. Am J Med Sci. 2015;349(3):199–205. CrossRef Han F. Early initiation of continuous renal replacement therapy improves clinical outcomes in patients with acute respiratory distress syndrome. Am J Med Sci. 2015;349(3):199–205. CrossRef
5.
go back to reference Timsit JF. Usefulness of a strategy based on bronchoscopy with direct examination of bronchoalveolar lavage fluid in the initial antibiotic therapy of suspected ventilator-associated pneumonia. Intens Care Med. 2001;27(4):640–7. CrossRef Timsit JF. Usefulness of a strategy based on bronchoscopy with direct examination of bronchoalveolar lavage fluid in the initial antibiotic therapy of suspected ventilator-associated pneumonia. Intens Care Med. 2001;27(4):640–7. CrossRef
6.
go back to reference Park JY. Early initiation of continuous renal replacement therapy improves survival of elderly patients with acute kidney injury: a multicenter prospective cohort study. Crit Care. 2016;20:1. CrossRef Park JY. Early initiation of continuous renal replacement therapy improves survival of elderly patients with acute kidney injury: a multicenter prospective cohort study. Crit Care. 2016;20:1. CrossRef
7.
go back to reference Stads S. Impaired kidney function at hospital discharge and long-term renal and overall survival in patients who received CRRT. Clin J Am SocNephro. 2013;8(8):1284–91. CrossRef Stads S. Impaired kidney function at hospital discharge and long-term renal and overall survival in patients who received CRRT. Clin J Am SocNephro. 2013;8(8):1284–91. CrossRef
8.
go back to reference Woodside KJ. Pneumothorax in patients with acute respiratory distress syndrome: pathophysiology, detection, and treatment. J Intensive Care Med. 2016;18(1):9–20. CrossRef Woodside KJ. Pneumothorax in patients with acute respiratory distress syndrome: pathophysiology, detection, and treatment. J Intensive Care Med. 2016;18(1):9–20. CrossRef
9.
go back to reference Boussarsar M. Relationship between ventilatory settings and barotrauma in the acute respiratory distress syndrome. Intens Care Med. 2002;28(4):406–13. CrossRef Boussarsar M. Relationship between ventilatory settings and barotrauma in the acute respiratory distress syndrome. Intens Care Med. 2002;28(4):406–13. CrossRef
10.
go back to reference Coopersmith CM. Surviving sepsis campaign: Research priorities for sepsis and septic shock. Crit Care Med. 2018;46(8):1334–56. CrossRef Coopersmith CM. Surviving sepsis campaign: Research priorities for sepsis and septic shock. Crit Care Med. 2018;46(8):1334–56. CrossRef
11.
go back to reference Aubron C. Intravenous immunoglobulin for adjunctive treatment of severe infections in ICUs. CurrOpin Crit Care. 2019;25(5):417–22. CrossRef Aubron C. Intravenous immunoglobulin for adjunctive treatment of severe infections in ICUs. CurrOpin Crit Care. 2019;25(5):417–22. CrossRef
Metadata
Title
Successful treatment of severe pneumonia, pyopneumothorax with severe acute respiratory distress syndrome, and septic shock: a case report
Authors
Xi Wang
Jian Lan
Ruijie Zhang
Xiaoqing Luo
Publication date
01-12-2020
Publisher
BioMed Central
Published in
European Journal of Medical Research / Issue 1/2020
Electronic ISSN: 2047-783X
DOI
https://doi.org/10.1186/s40001-020-00459-6

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