Treatment of a Patient with NPPV Who Developed ARDS Caused by Community- Acquired Pneumonia: A Case Report

Öz

Introduction: Although the benefits of noninvasive positivepressure ventilation (NPPV) in the presence of acute exacerbations of chronic obstructive pulmonary diseases and pulmonary edema of cardiac origin have been determined clearly, the role of NPPV is still controversial in acute respiratory distress syndrome (ARDS). However, recent studies have shown an increased rate of success.Case Report: A 38-year-old female patient with ARDS due to serious community-acquired pneumonia, which was probably caused by a viral infection, was hospitalized in the intensive care unit. The patient was treated successfully with NPPV, a less invasive technique, in spite of her need for invasive mechanical ventilation (IMV).Conclusion: NPPV accompanying appropriate antibiotics can be used as an alternative method for the treatment of ARDS in intensive care units for patients with normal muscle strength and are conscious to avoid the side effects of IMV

Anahtar Kelimeler

• ARDS, noninvasive positive pressure ventilation, community acquired pneumonia

Toplum Kaynaklı Pnömoniye Bağlı ARDS Gelişen Hastanın NİPBV ile Tedavisi: Olgu Sunumu

Öz

Giriş: Kronik obstrüktif akciğer hastalığının akut alevlenmelerinde ve kardiyak nedenli pulmoner ödem varlığında Non-invaziv pozitif basınçlı ventilasyonun (NİPBV) faydaları iyi tespit edilmesine karşın akut sıkıntılı solunum sendromunda (ARDS) NİPBV'nin rolü tartışmalıdır. Ancak son çalışmalarda başarı oranının arttığı gösterilmiştir. Olgu Sunumu: 38 yaşında bayan hasta, muhtemel viral enfeksiyon sonrası gelişen ciddi toplum kökenli pnömoniye (TKP) bağlı ARDS tanısıyla yoğun bakım ünitesinde yatırıldı. İnvaziv mekanik ventilasyon (İMV) gerekmesine rağmen İMV'a göre daha az komplikasyonları olan NİPBV ile başarılı bir şekilde tedavi edildi. Sonuç: NİPBV, yoğun bakım şartlarında ARDS tedavisi için, uygun antibiyoterapi ile birlikte, kas gücü yerinde ve bilinci açık hastalarda İMV'nin yan etkilerinden kaçınmak için alternatif olarak kullanılabilecek bir yöntem olabilir.

Anahtar Kelimeler

• ARDS, non-invazif pozitif basınçlı ventilasyon, toplum kökenli pnömoni

Kaynakça

1. Antonelli M, Conti G, Esquinas A, Montini L, Maggiore SM, Bello G, et al. A multiple-center survey on the use in clinical practice of noninvasive ventilation as a first-line intervention for acute respiratory distress syndrome. Crit Care Med 2007; 35: 18-25. [CrossRef]
2. Aqarwal R, Aqqarwal AN, Gupta D. Role of noninvasive ventilation in acute lung injury/acute respiratory distress syndrome: a proportion meta-analysis. Respir Care 2010; 55: 1653-60.
3. Antonelli M, Conti G, Rocco M, Bufi M, De Balasi RA, Vivino G, et al. A comparison of noninvasive positive-pressure ventilation and conventional mechanical ventilation in patients with acute respiratory failure. N Engl J Med 1998; 339: 429-35. [CrossRef]
4. Nicolini A, Ferraioli G, Senarega R. Severe Legionella pneumophila pneumonia and non-invasive ventilation: presentation of two cases and brief review of the literature. Pneumonol Alergol Pol 2013; 81: 399-403.
5. Alves DW, Kennedy MT. Community-acquired pneumonia in casualty: Etiology, clinical features, diagnosis, and management (or a look at the “new” in pneumonia since 2002). Curr Opin Pulm Med 2004; 10: 166-70. [CrossRef]
6. Bircan A, Kaya Ö, Gökırmak M, Öztürk Ö, Şahin Ü, Akkaya A. C-reactive protein, leukocyte count and ESR in theassessment of severity of community-acquired pneumonia. Tuberk Toraks 2006; 54: 22-9.
7. The American-European Consensus Conference on ARDS. Am J Respir Care Med 1994; 149: 824.
8. Uçgün İ, Yıldırım H, Metintaş M, Ak G. The efficacy of non-invasive positive pressure ventilation in ARDS: A controlled cohort study. Tüberk Toraks 2010; 58: 16-24.

9. Yamauchi LY, Travaglia TC, Bernardes SR, Figueiroa MC, Tanaka C, Fu C. Noninvasive positive-pressure ventilation in clinical practice at a large university-affiliated Brazilian hospital. Clinics (Sao Paulo) 2012; 67: 767-72. [CrossRef]
10. Esteban A, Anzueto A, Frutos F, Alía I, Brochard L, Stewart TE, et al. Characteristics and outcome in adult patients receiving mechanical ventilation: a 28-day international study. JAMA 2002; 287: 345-55. [CrossRef]