Management of postoperative ards with new methods of noninvasive ventilation in a polytrauma patient

Authors:Pradnya Jagtap, Sandhya Gujar, Shirish Chavan, Sanjay Patil.
Int J Biol Med Res. 2013; 4(3): 3429-3431  |  PDF File

Abstract

33 year old patient came with multiple fractures. After optimizing patientís condition, it was decided to give CSE and interscalene block .Surgery was conducted successfully. On next day, patient developed signs and symptoms of ARDS. Initially he was managed with oxygen by mask. Patient developed hypoxemia, hypercapnia and acidosis with base deficit. So patient was put on NIV (BIPAP). He was given supportive treatment. After 48 hours, patient started improving and maintaining vital parameters. He was successfully weaned off with noninvasive methods of ventilation. And he was later discharged. Acute respiratory distress syndrome is an acute hypoxemic respiratory failure with lung edema of non-cardiac origin. Its primary treatment is mechanical ventilation with endotracheal intubation (positive pressure ventilation). BIPAP is pressure limited, time cycled, spontaneous mode of ventilation which allows spontaneous breathing and low tidal ventilation. It helps in maintaining gas exchange, cardiovascular stability, reducing or eliminating need for heavy sedation and muscle relaxant and shorter duration of ICU stay.