Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue · 2003
[Preliminary analysis of treatment in 32 patients with critical severe acute respiratory syndrome].
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Lu Wei, Zhang Hong-sheng, Wang Feng-mei, Wang Shao-jun, Wu Xiao-di, Zhang Na-xin, Kan Zhi-chao, Qin Ying-zhi, Xiao Lang
Аннотация
OBJECTIVE: To summarize the experience of treatment in 32 critical severe acute respiratory syndrome (SARS) patients.
METHODS: The age of 32 patients ranged from 19 to 72 years, the average was 43.06 years. Among them, 13 patients were having serious primary diseases, i.e. cardio-cerebral-vascular disease in 9 patients, diabetes in 2 patients, renal dysfunction in 1 patient, and chronic obstructive pulmonary disease (COPD) in 1 patient. The treatment included antiviral agents, glucocorticoid, mechanical ventilation, antibiotics and immunologic enhancement, etc. Cure rate, mortality and complications were analyzed.
RESULTS: Among 32 patients, 24 were cured, 2 died of respiratory failure, 6 died of their primary diseases, and the overall mortality was 25.00 percent. Superimposed infection occurred in 12 patients, and among 17 patients who required noninvasive ventilation, 3 patients were complicated by lung injury (mediastinal emphysema, pneumothorax). In addition, hyperglycemia was found in 4 patients, upper intestinal hemorrhage occurred in another 4 patients and cardiac failure occurred in 6 patients.
CONCLUSION: The treatment of the pre-existing diseases should be emphasized in the treatment of critical SARS. Glucocorticoid should not be used for a long-term. Vigilance should be paid to avoid lung injury during mechanical ventilation.
METHODS: The age of 32 patients ranged from 19 to 72 years, the average was 43.06 years. Among them, 13 patients were having serious primary diseases, i.e. cardio-cerebral-vascular disease in 9 patients, diabetes in 2 patients, renal dysfunction in 1 patient, and chronic obstructive pulmonary disease (COPD) in 1 patient. The treatment included antiviral agents, glucocorticoid, mechanical ventilation, antibiotics and immunologic enhancement, etc. Cure rate, mortality and complications were analyzed.
RESULTS: Among 32 patients, 24 were cured, 2 died of respiratory failure, 6 died of their primary diseases, and the overall mortality was 25.00 percent. Superimposed infection occurred in 12 patients, and among 17 patients who required noninvasive ventilation, 3 patients were complicated by lung injury (mediastinal emphysema, pneumothorax). In addition, hyperglycemia was found in 4 patients, upper intestinal hemorrhage occurred in another 4 patients and cardiac failure occurred in 6 patients.
CONCLUSION: The treatment of the pre-existing diseases should be emphasized in the treatment of critical SARS. Glucocorticoid should not be used for a long-term. Vigilance should be paid to avoid lung injury during mechanical ventilation.