Noninvasive positive pressure ventilation combined hormone therapy of acute chlorine poisoning caused by ARDS 1 Li.doc

 PAGE \* MERGEFORMAT 10 Noninvasive positive pressure ventilation combined hormone therapy of acute chlorine poisoning caused by ARDS 1 Li Keywords:: Hormone For high-water-soluble irritant chlorine gas, solubility in water, large, moist in the eyes and respiratory tract quickly dissolves the surface of the formation of the organization and the new eco-oxygen acids, resulting in a strong stimulation and oxidation. Clinical symptoms of chlorine poisoning can be as follows: eye and upper respiratory tract irritation, acute tracheal bronchitis, toxic pneumonia, acute respiratory distress syndrome, as well as late-onset bronchiolitis obliterans and so on. Now admitted to our department with acute chlorine poisoning caused by the use of non-invasive positive pressure ventilation in ARDS rescue in 1 case reported as follows. A medical summary of Patients, female, 43-year-old chemical plant worker, due to inhalation of chlorine in the production process, after feeling chest 30min Bie, palpitations discomfort, 3h after the chest choke increased chest pain, shortness of breath, irritability treatment, examination: body temperature 37 ℃, respiration 36 times / min, pulse 108 times / min, blood pressure 120/65mmHg (1mmHg = 0.133kPa), God-ching, fear face, lungs can be heard and the volume of medium and small blisters on the middle tone, blood gas: pH 7.38, PCO2 38mmHg, PO2 69mmHg, A -aDO2 90mmHg (FiO2 40%), chest X-ray double-lung field with multiple-point sheet shadows. 6h increased incidence of disease, chest suffocation and promote clear, RR 54 times / min, P 118 times / min, blood gas analysis: pH 7.40, PCO2 29mmHg, PO2 55mmHg, A-aDO2 267mmHg (FiO2 50%), chest X-ray showed bilateral pulmonary plaques films of increasing integration of increasing right lower lung. Consider the diagnosis of ARDS was established [1], to give 320mg of methylprednisolone infusion, 8h 1 times, two days after the reduct