Successful Treatment of a Child with Acute Respiratory Distress Syndrome (ARDS)
Úspešná liečba dieťaťa so syndrómom dychovej tiesne (ARDS)
Autori opisujú 10-ročné dievča, ktoré bolo prijaté a liečené antibiotikami pre sínusitídu, potom hnačkové ochorenie. Pre pretrvávanie vysokých teplôt urobili lumbálnu punkciu a vylúčili meningitídu. Klinický stav dieťaťa sa zhoršoval, pridružila sa tachykardia, tachypnoe a cyanóza. Autori diagnostikovali syndróm dychovej tiesne. Pacientku preložili na jednotku intenzívnej starostlivosti, intubovali a ventilovali. Urobili aj pľúcnu biopsiu, kde histologia ukázala ťažkú DAD (diffuse alveolar damage). Kedže sa stav zhoršoval, prehlbovala sa hypoxémia a hyperkapnia napriek maximálnym ventilačným parametrom a 100% kyslíku, rozhodli sa nasadiť pulznú liečbu kortikosteroidmi a imunosupresívnu liečbu Cyklofosfamidom, ktorú dieťa dostávalo po dobu 3 mesiacov. Stav sa postupne zlepšoval a HRCT nález na pľúciach sa neuveriteľne upravil. Vzhľadom na to, že v dostupnej literatúre sú kontraverzné názory na liečbu kortikosteroidmi a vôbec sa nezmieňujú o imunosupresívnej liečbe, je otázne, či táto liečba spôsobila taký zvrat ochorenia.
Kľúčové slová:
akútny syndróm dychovej tiesne v detskom veku
Authors:
B. Spišák 1; Ľ. Podracká 2; A. Böör 2; M. Kurák 3; A. Feketeová 1; P. Mach 4
Authors place of work:
I. Klinika detí a dorastu LF UPJŠ a DFN, Košice
prednostka prof. MUDr. Ľ. Podracká, CSc.
1; Ústav patológie LF UPJŠ, Košice
prednosta prof. MUDr. A. Böör, CSc.
2; Oddelenie intenzívnej medicíny DFN, Košice
prim. MUDr. M. Pisarčíková, PhD.
3; I. klinika rádiodiagnostiky a zobrazovacích metód LF UPJŠ, Košice
prednosta MUDr. P. Mach, CSc.
4
Published in the journal:
Čes-slov Pediat 2006; 61 (1): 26-31.
Category:
Case Report
Summary
The authors describe a 10-year girl who was admitted and treated as sinusitis, then as a diarrhea with the use of antibiotics. The lasting high fever indicated possible meningitis, which was excluded after lumbar puncture. The clinical picture of the child deteriorated and there was additional tachycardia, tachypnea and cyanosis. The acute respiratory distress syndrome was diagnosed. The patient was transferred to the Intensive Care Unit, intubated and artificially ventilated. Lung biopsy was made and histology established a severe DAD (diffuse alveolar damage). Since the condition further deteriorated, hypoxemia became more severe as well as hypercapnia in spite of maximum ventilation parameters and 100% oxygen, the authors decided to treat the patient with pulse therapy with corticoids as well as immunosuppressive therapy with cyclophosphamide, which was administered for the period of three months. The condition gradually´improved and HRTC finding of the lungs showed an unbelievable improvement. In view of the controversial opinions on the therapy with corticoids in available literature and no information about immunosuppressive therapy there is still open question what the twist of the disease caused.
Key words:
acute respiratory distress syndrome at the child age
Štítky
Neonatology Paediatrics General practitioner for children and adolescentsČlánok vyšiel v časopise
Czech-Slovak Pediatrics
2006 Číslo 1
- What Effect Can Be Expected from Limosilactobacillus reuteri in Mucositis and Peri-Implantitis?
- The Importance of Limosilactobacillus reuteri in Administration to Diabetics with Gingivitis
Najčítanejšie v tomto čísle
- Hydrops Fetalis
- Byler Syndrome – A Case Report
- Successful Treatment of a Child with Acute Respiratory Distress Syndrome (ARDS)
- The Problem of Pertussis at the Child Age