Abstract:
This patient is a 67-year-old man who initially presented to our facility with acute respiratory failure secondary to COVID-19. Soon after arrival at our facility, the patient decompensated, developing severe acute respiratory distress syndrome requiring intubation and prone positioning to maintain adequate oxygenation. During the next few days, acute kidney injury with oliguria and severe volume overload developed. The vascular surgery service was consulted to obtain central venous access for emergent continuous renal replacement therapy. On examination, the patient was sedated and paralyzed in a rotating prone-positioning bed. He could not be positioned supine without immediately becoming hypoxic and decompensating. A 50-cm Permcath (Medtronic, Santa Rosa, Calif) was inserted through the left popliteal vein. This case report outlines a possible challenging scenario that the vascular interventionist may encounter in dealing with COVID-19 patients with respiratory compromise in the prone position.
摘要:
该患者是一名67岁的男子,最初因COVID-19继发急性呼吸衰竭来到我们的设施。到达我们的设施后不久,患者代偿失调,发展为严重的急性呼吸窘迫综合征,需要插管和易于定位以维持足够的氧合。在接下来的几天里,急性肾损伤伴少尿和严重容量超负荷。咨询了血管外科服务,以获得紧急连续肾脏替代疗法的中心静脉通路。在检查中,患者在旋转的俯卧位床上镇静并瘫痪。如果不立即缺氧和失代偿,他就无法仰卧。50厘米的Permcath(美敦力,圣罗莎,Calif)通过左the静脉插入。本病例报告概述了血管介入医生在处理俯卧位呼吸受损的COVID-19患者时可能遇到的一种可能具有挑战性的情况。