Abstract

RIVERA CHAVEZ, Manuel José; VALERO RODRIGUEZ, Julián Enrique  and  VALERO VIDAL, Maximiliano. Monitoring of residual functional capacity in patients with severe acute respiratory distress syndrome. Case report and review of the literature. Med. crít. (Col. Mex. Med. Crít.) [online]. 2016, vol.30, n.5, pp.324-328. ISSN 2448-8909.

We report the case of a male patient of the 5th decade of life with a diagnosis of renal tumor. Is entered surgery for selective embolization of renal artery ipsilateral to the site of the tumor lesion. During Trans operative, presented massive bleeding, receiving multiple transfusions, requiring admission to intensive care unit. Acute kidney injury (AKIN III) was documented, severe acute respiratory distress syndrome (ARDS) development according to criteria of Berlin 2012. Unconventional modes of ventilation among which were reverse ventilation, bi-level (APRV) and PRVC were used without improvement. It was decided to change recruitment strategy led by FRC in view, with improved ventilation parameters and levels of FiO2. Poor outcome with subsequent development of pancreatitis and bleeding requiring reoperation with subsequent death of the patient. Case presentation and review of the literature for recruitment maneuvers guided by FRC in view is performed.

Keywords : Acute respiratory distress syndrome; recruitment maneuvers; functional residual capacity.

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