Efficiency of noninvasive mechanical ventilation and high flow nasal oxygen therapy in moderate acute respiratory distress syndrome due to pneumonia

Yıl 2018, Cilt: 10 Sayı: 2, 62 - 66, 01.08.2018

Ümit Gökhan Şendur Fatma İrem Yeşiler Osman Yüksekyayla

Öz

Acute Respiratory Distress Syndrome ARDS is hypoxemic respiratory failure that is characterized by non-cardiac pulmonary edema secondary to increased vascular permeability. It is associated with increased mortality and morbidity. The important cilinical features of ARDS are; new or worsening symptoms during the past week, bilateral radiological infiltrations, hypoxemia refractory to oxygen therapy. Community-acquired pneumonia CAP is he most common cause of ARDS in out-patients. Noninvasive mechanical ventilation NIMV and / or high-flow nasal oxygen HFNC therapy should be applied before intubation in selected patients and the early phases of ARDS but invasive mechanical ventilation IMV should not be delayed if the patient deteriorates. We report to demonstrate efficiency of NIMV and HFNC in two cases with moderate ARDS due to CAP

Anahtar Kelimeler

Acute Respiratory Distress Syndrome ARDS, noninvasive mechanical ventilation NIMV, high-flow nasal oxygen HFNC, pneumonia

Pnömoniye bağlı orta akut respiratuar distres sendromunda noninvaziv mekanik ventilasyon ve yüksek akım nazal oksijen tedavisinin etkinliği

Öz

Akut Respiratuar Distres Sendromu ARDS , vasküler permeabilite artışına sekonder oluşan kardiyak olmayan akciğer ödemi ile karakterize hipoksemik solunum yetmezliği tablosudur. Yüksek mortalite ve morbidite oranına sahiptir. ARDS’nin önemli klinik özellikleri; son bir hafta içinde yeni gelişen ya da kötüleşen akciğer semptomları, bilateral radyolojik infiltrasyonlar ve oksijen tedavisine dirençli arteriyel hipoksemidir. Hastanede yatış öyküsü olmayan hastalarda ARDS’nin en sık nedeni toplumda gelişen pnömonidir. Erken dönem ARDS ve uygun olgularda entübasyondan önce noninvaziv mekanik ventilasyon NIMV ve/veya yüksek akım nazal oksijen HFNC tedavisi denenmelidir ancak bu tedavilerle yanıt alınamayan vakalarda invaziv mekanik ventilasyon İMV uygulaması geciktirilmemelidir. İki olgumuzu da toplumda gelişen pnömoniye bağlı orta ARDS yönetiminde uygulanan NIMV ve HFNC tedavisinin etkinliğini göstermek amacıyla sunuyoruz.

Anahtar Kelimeler

Akut Respiratuar Distres Sendromu ARDS, noninvaziv mekanik ventilasyon NIMV, yüksek akım nasal oksijen HFNC, pnömoni

Kaynakça

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