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VOLUME 21 , ISSUE 5 ( May, 2017 ) > List of Articles

CASE REPORT

Severe pediatric acute respiratory distress syndrome due to scrub typhus: Successful ventilation with airway pressure release ventilation mode after becoming refractory to protective ventilation

Sarika Jain, Sudha Chandelia

Keywords : airway pressure release ventilation, pediatric, scrub typhus,Acute respiratory distress syndrome

Citation Information : Jain S, Chandelia S. Severe pediatric acute respiratory distress syndrome due to scrub typhus: Successful ventilation with airway pressure release ventilation mode after becoming refractory to protective ventilation. Indian J Crit Care Med 2017; 21 (5):326-328.

DOI: 10.4103/ijccm.IJCCM_38_17

License: CC BY-ND 3.0

Published Online: 00-05-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Scrub typhus can affect lungs from mild illness like pneumonitis to a severe illness like acute respiratory distress syndrome (ARDS). Such patients may be very challenging to treat when their hypoxemia becomes severe and refractory to treatment. Main treatment is supportive in terms of mechanical ventilation. In adult ARDS, low tidal volume (TV) ventilation has been recommended, but there is no consensus on most effective ventilation mode in children. We present a case of a 12-year-old girl who developed severe ARDS (PO 2 /FiO 2 ratio - 58), refractory to low TV ventilation. There was a rapid improvement in oxygenation on the application of airway pressure release ventilation (APRV) mode within ½ h. She was successfully ventilated and weaned off the ventilator over 5 days. This case highlights the utility of APRV mode of ventilation as a rescue therapy for severe refractory ARDS in children.


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