KMID : 1155520240190020144
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Anesthesia and Pain Medicine 2024 Volume.19 No. 2 p.144 ~ p.149
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Early diagnosis of negative-pressure pulmonary edema presenting as diffuse alveolar hemorrhage using lung ultrasonography -A case report-
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Son Hee-Won
Kang Yun-Ho Ahn Young-Ick Oh Ji-Mi
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Abstract
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Background: Diffuse alveolar hemorrhage (DAH) is a potentially life-threatening condition that can occur due to a variety of disorders. Hence, rapid diagnosis and prompt initiation of appropriate treatment are imperative.
Case: A 55-year-old woman with a deep neck infection underwent emergent tonsillectomy. General anesthesia and surgery proceeded uneventfully. Upon transfer to the post-anesthesia care unit, ongoing respiratory distress and occasional expectoration of blood-tinged sputum were noted. Lung ultrasonography (LUS) revealed multiple B-profiles and irregular pleural lines with subpleural consolidations. Emergent bronchoscopy with bronchoalveolar lavage was diagnostic of DAH. She underwent a comprehensive evaluation for rheumatologic and infectious etiologies of DAH, all of which yielded negative results. The patient was managed with steroids and conservative treatment.
Conclusions: The integration of LUS with clinical information allows for more rapid differentiation of acute respiratory failure causes. Therefore, anesthesiologists¡¯ awareness and utilization of LUS findings of DAH can significantly contribute to appropriate management.
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KEYWORD
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Postoperative complication, Postoperative hemorrhage, Pulmonary edema, Sevoflurane, Tonsillectomy, Ultrasonography
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