Prolonged Respiratory Failure With Pulmonary Fibroproliferative Complications Following Severe Drowning-Associated ARDS: A Case Report.
Katsutoshi Saito, Yoshihiro Miyake, Tomohiro Abe et al.
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Case in brief
A 15-year-old girl experienced severe acute respiratory distress syndrome (ARDS) after a drowning incident, with an initial PaO2/FiO2 ratio of 54.4. Her condition was complicated by mediastinal emphysema and recurrent bilateral pneumothorax, requiring multiple chest tube insertions. After intensive treatment, including steroid pulses and nitric oxide inhalation, her respiratory function improved, allowing for successful extubation on day 53 and discharge on day 93.
What made this case unusual
The case is notable for the prolonged respiratory failure and fibroproliferative changes following drowning-associated ARDS, which are rarely reported.
Diagnostic / clinical pearl
Clinicians should be aware that drowning-associated ARDS can lead to prolonged respiratory failure and complications, necessitating vigilant management.
Why it matters
This case underscores the potential for partial reversibility in severe ARDS, highlighting the need to avoid premature conclusions about patient outcomes.