Progressive respiratory insufficiency developed with peak airway pressures in excess of 90 cm H,0. Progressive roentgenogram changes consistent with the adult respiratory distress syndrome were recognized, with pulmonary artery catheterization confirming the presence of noncardiogenic pulmonary edema. On the 19th hospital day, a left-sided tension pneumothorax developed requiring tube thoracostomy. Two days later, she suffered a cardiac arrest and could not be resuscitated. canadian health & care mall
An 88-year-old white woman was transferred to Harper Hospital following a 36-hour hospitalization at a community hospital for dyspnea, nausea, vomiting, and diarrhea. Her respiratory status had rapidly deteriorated requiring endotracheal intubation and mechanical ventilatory support. Findings from the physical examination, both on presentation to the community hospital and on transfer to the tertiary care institution, were described as unremarkable. Arterial blood gases on transfer while receiving an oxygen concentration of 80 percent and 8 cm HsO of positive end-expiratory pressure revealed a Po2 of 77 mm Hg, a Pcos of 28 mm Hg, and a pH of 7.45. The chest roentgenogram revealed diffiise bilateral parenchymal infiltrates. The temperature was 38.3°C, but all other vital signs were stable.