Severe Progressive Diffuse Alveolar Hemorrhage in a Patient with Systemic Lupus Erythematosus
Diffuse alveolar hemorrhage (DAH) refers to the effusion of blood into the alveoli due to damaged pulmonary microvasculature. The ensuing alveolar collapse can lead to severe hypoxemia with poor prognosis. In these cases, it is crucial to provide respiratory care for hypoxemia in addition to treatin...
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| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Critical Care |
| Online Access: | http://dx.doi.org/10.1155/2018/9790459 |
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| _version_ | 1850169654746546176 |
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| author | Munenori Kusunoki Takeshi Umegaki Tomohiro Shoji Kota Nishimoto Natsuki Anada Akiko Ando Takeo Uba Kanako Oku Saya Hakata Satoshi Hagihira Takahiko Kamibayashi |
| author_facet | Munenori Kusunoki Takeshi Umegaki Tomohiro Shoji Kota Nishimoto Natsuki Anada Akiko Ando Takeo Uba Kanako Oku Saya Hakata Satoshi Hagihira Takahiko Kamibayashi |
| author_sort | Munenori Kusunoki |
| collection | DOAJ |
| description | Diffuse alveolar hemorrhage (DAH) refers to the effusion of blood into the alveoli due to damaged pulmonary microvasculature. The ensuing alveolar collapse can lead to severe hypoxemia with poor prognosis. In these cases, it is crucial to provide respiratory care for hypoxemia in addition to treating the underlying disease. Here, we describe our experience with a case involving a 46-year-old woman with severe DAH-induced hypoxemia accompanying systemic lupus erythematosus (SLE). Mechanical ventilation was managed using airway pressure release ventilation (APRV) after intubation. Through APRV-based respiratory care and treatment of the underlying disease, hemoptysis was eliminated and oxygenation improved. The patient did not experience significant barotrauma and was successfully weaned from mechanical ventilation after 25 days in the intensive care unit. This case demonstrates that APRV-based control for respiratory management can inhibit the effusion of blood into the alveoli and achieve mechanical hemostasis, as well as mitigate alveolar collapse. APRV may be a useful method for respiratory care in patients with severe DAH-induced hypoxemia. |
| format | Article |
| id | doaj-art-a9bed95de54d4a668b0da26ac5c2ad1d |
| institution | OA Journals |
| issn | 2090-6420 2090-6439 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Critical Care |
| spelling | doaj-art-a9bed95de54d4a668b0da26ac5c2ad1d2025-08-20T02:20:41ZengWileyCase Reports in Critical Care2090-64202090-64392018-01-01201810.1155/2018/97904599790459Severe Progressive Diffuse Alveolar Hemorrhage in a Patient with Systemic Lupus ErythematosusMunenori Kusunoki0Takeshi Umegaki1Tomohiro Shoji2Kota Nishimoto3Natsuki Anada4Akiko Ando5Takeo Uba6Kanako Oku7Saya Hakata8Satoshi Hagihira9Takahiko Kamibayashi10Department of Anesthesiology, Kansai Medical University Hospital, Osaka, JapanDepartment of Anesthesiology, Kansai Medical University Hospital, Osaka, JapanDepartment of Anesthesiology, Kansai Medical University Hospital, Osaka, JapanDepartment of Anesthesiology, Kansai Medical University Hospital, Osaka, JapanDepartment of Anesthesiology, Kansai Medical University Hospital, Osaka, JapanDepartment of Anesthesiology, Kansai Medical University Hospital, Osaka, JapanDepartment of Anesthesiology, Kansai Medical University Hospital, Osaka, JapanDepartment of Anesthesiology, Kansai Medical University Hospital, Osaka, JapanDepartment of Anesthesiology, Kansai Medical University Hospital, Osaka, JapanDepartment of Anesthesiology, Kansai Medical University Hospital, Osaka, JapanDepartment of Anesthesiology, Kansai Medical University Hospital, Osaka, JapanDiffuse alveolar hemorrhage (DAH) refers to the effusion of blood into the alveoli due to damaged pulmonary microvasculature. The ensuing alveolar collapse can lead to severe hypoxemia with poor prognosis. In these cases, it is crucial to provide respiratory care for hypoxemia in addition to treating the underlying disease. Here, we describe our experience with a case involving a 46-year-old woman with severe DAH-induced hypoxemia accompanying systemic lupus erythematosus (SLE). Mechanical ventilation was managed using airway pressure release ventilation (APRV) after intubation. Through APRV-based respiratory care and treatment of the underlying disease, hemoptysis was eliminated and oxygenation improved. The patient did not experience significant barotrauma and was successfully weaned from mechanical ventilation after 25 days in the intensive care unit. This case demonstrates that APRV-based control for respiratory management can inhibit the effusion of blood into the alveoli and achieve mechanical hemostasis, as well as mitigate alveolar collapse. APRV may be a useful method for respiratory care in patients with severe DAH-induced hypoxemia.http://dx.doi.org/10.1155/2018/9790459 |
| spellingShingle | Munenori Kusunoki Takeshi Umegaki Tomohiro Shoji Kota Nishimoto Natsuki Anada Akiko Ando Takeo Uba Kanako Oku Saya Hakata Satoshi Hagihira Takahiko Kamibayashi Severe Progressive Diffuse Alveolar Hemorrhage in a Patient with Systemic Lupus Erythematosus Case Reports in Critical Care |
| title | Severe Progressive Diffuse Alveolar Hemorrhage in a Patient with Systemic Lupus Erythematosus |
| title_full | Severe Progressive Diffuse Alveolar Hemorrhage in a Patient with Systemic Lupus Erythematosus |
| title_fullStr | Severe Progressive Diffuse Alveolar Hemorrhage in a Patient with Systemic Lupus Erythematosus |
| title_full_unstemmed | Severe Progressive Diffuse Alveolar Hemorrhage in a Patient with Systemic Lupus Erythematosus |
| title_short | Severe Progressive Diffuse Alveolar Hemorrhage in a Patient with Systemic Lupus Erythematosus |
| title_sort | severe progressive diffuse alveolar hemorrhage in a patient with systemic lupus erythematosus |
| url | http://dx.doi.org/10.1155/2018/9790459 |
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