A successfully treated case of aspiration pneumonia with adult respiratory distress syndrome and shock
Ehira, N.; Kudoh, A.; Katagai, H.; Takazawa, T.
Masui. Japanese Journal of Anesthesiology 51(5): 535-538
2002
ISSN/ISBN: 0021-4892 PMID: 12058443 Document Number: 549965
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 cntdot 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.