[A successfully treated case of aspiration pneumonia with adult respiratory distress syndrome and shock].
Right hip replacement was scheduled for a 74-year-old man who was treated with morphine for cancer pain. As the patient developed dyspnea and hypoxia after anesthesia, he was intubated and kept under mechanical ventilation. A diagnosis of aspiration pneumonia with adult respiratory distress syndrome was made based on the detection of gall obtained from the endotracheal tube. A chest X-ray showed pulmonary edema. He was treated with positive pressure ventilation and inotropic support. As he developed severe shock 10 hours after the intubation, he was treated with 20 mg.kg-1 of methylprednisolone for 3 days. The steroid therapy was successful and he was extubated on the 6th postoperative day and was discharged from the ICU on the 7th postoperative day. High-dose pulse methylprednisolone therapy resulted in a remarkable clinical improvement. Corticosteroids rescue treatment is effective for such a severe case of aspiration pneumonia with shock when the treatment is done in the early phase of the pneumonia.
Ehira
Nobuyuki
N
Medical Student of University of Hirosaki School of Medicine, Hirosaki 036-8203.
Kudoh
Akira
A
Katagai
Hiroshi
H
Takazawa
Tomoko
T
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D011015:Pneumonia, Aspiration / Q000188:drug therapy*; D012128:Respiratory Distress Syndrome / Q000209:etiology*; D012769:Shock / Q000209:etiology*
D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone