Chest roentgenogram revealed further progression of bilateral pulmonary infiltrates consistent with the adult respiratory distress syndrome (Fig 3). Pulmonary artery catheterization confirmed the presence of noncardiogenic pulmonary edema, with a pulmonary capillary wedge pressure of 10 mm Hg, a cardiac output of 9.5 LJ min, and a mean pulmonary artery pressure of 21 mm Hg. Intravenous methylprednisolone therapy was started at the same time as mechanical ventilation was initiated. Cheap Diskus Advair
Despite ventilatory support, pulmonary compliance fell and oxygenation became difficult to achieve. Peak airway pressures rose to 90 cm HjO. On the 15th hospital day, a spontaneous right tension pneumothorax developed, requiring thoracostomy. On the 21st hospital day, a left-sided pneumothorax developed. Despite decompression, the patient suffered a cardiac arrest and died.
A 40-year-old white woman was transferred to Henry Ford Hospital because of respiratory insufficiency. She had been hospitalized at a community hospital for one day with a history of dyspnea, nausea, vomiting, and diarrhea. Other than a temperature of 37.2°C and mild tachypnea, results of her physical examination were normal. Room air arterial blood gases revealed a Po2 of 71 mm Hg, a Pcos of 36 mm Hg, and a pH of 7.44.
Figure 3. Chest roentgenogram revealing progression of bilateral infiltrates consistent with the adult respiratory distress syndrome.