Recently, the Department of Respiratory and Critical Care Medicine of Peking Union Medical College Hospital received an interesting pennant with eight letters printed on it "RICU YYDS", which seems to be a short eight letters but expresses the most sincere gratitude of mr. Meng, a patient. Mr. Meng was admitted to the hospital urgently due to respiratory failure, and with the joint efforts of multiple disciplines such as respiratory and critical care medicine and emergency department, the patient's condition tended to be stable, and he was successfully discharged from the hospital after more than half a month. 5 days later, it was his birthday, "Thank you very much to the doctor of Concordia, Concordia gave me the most precious birthday gift. ”
A month ago, Mr. Meng suddenly had symptoms of low-grade fever, dry cough, and breath holding, and his condition developed rapidly, and in less than three days, he could only continue to stay in bed, "eating and drinking Lasa can not breathe." On February 26, Mr. Meng was treated at a hospital near his home. Chest CT examination reveals diffuse lesions in both lungs and bilateral pleural effusions. Due to the difficult condition, the patient was transferred to the Concordia Fever Clinic and the Internal Medicine Emergency Department of the International Medical Department in the afternoon. Mr. Meng, who has just been admitted to the hospital, has difficulty walking and needs a wheelchair to walk.
At 9:30 p.m., Mr. Meng's condition further deteriorated, dyspnea continued to worsen, blood oxygen saturation (SpO2) dropped from 90% to 84%, and renal function was abnormal. Chest imaging shows that the brightness of both lungs is reduced, and the double lungs are multiple patches, and the lesions are worse than before. Doctors continue to give them oxygen and empiric anti-infective therapy. "Quick, send to the rescue room!" At 23:55, the patient's condition took a sharp turn for the worse, shortness of breath, reaching 40-50 beats per minute, and was urgently sent to the emergency room for continued treatment.
▲Chest imaging shows that the brightness of both lungs is reduced, and there are multiple patches in both lungs
Early the next morning, the patient was transferred to the Intensive Care Unit (RICU) of the Respiratory and Critical Care Department. Dr. Wang Luo is the attending physician of Mr. Meng, and under the guidance of Professor Wang Jinglan, he clearly diagnosed Mr. Meng with severe pneumonia, type I respiratory failure, bilateral pleural effusion, and acute kidney injury. The question ensues, the patient is critically ill and respiratory distress, is this the best time for endotracheal intubation? If I don't intubate, will it cause delays in the patient's condition?
After discussion, the team of department experts decided cautiously: patients with severe community-acquired pneumonia are more likely, and should be actively supported by immunoglobulins, combined with antibiotic therapy to drain pleural effusion; temporarily do not perform endotracheal intubation, and use nasal high-flow oxygen therapy.
"We give patients and give ourselves a day to observe the efficacy. At the same time, we have also made a plan for aggravation of the disease. Dr. Wang Luo said. During these 24 hours, the medical staff paid attention to Mr. Meng's blood oxygen saturation, respiratory rate, heart rate and other vital signs day and night; always observed his breathing status, adjusted his respiratory support treatment parameters as needed; and closely assessed his consciousness, body temperature, cough and sputum, pleural effusion drainage, etc. "The heart rate we care for is directly related to the vital signs of our patients." Dr. Wang Luo said sincerely. On the second day of active treatment, as expected, Mr. Meng's condition gradually stabilized, and he was also exempted from the pain of endotracheal intubation and the risk of secondary infection.
A week later, Mr. Meng was transferred to the general ward to continue his treatment. A re-examination of the chest CT before discharge showed that the lesions in Mr. Meng's lungs were clearly absorbed.
"I have a special trust in Peking Union Medical College Hospital. My condition developed rapidly, and Concordia was my first choice for medical treatment. During my hospitalization, I felt the professionalism of RICU's medical diagnosis and treatment, as well as their care and care for patients. I'm really grateful. Therefore, Mr. Meng commissioned his lover to give a pennant to the Department of Respiratory and Critical Care Medicine, and insisted on writing "YYDS (Internet term: Eternal God)", "because this is the truest thought in my heart." ”
As one of the earliest respiratory professional departments established in mainland China, as well as a respiratory diagnosis and treatment center, the Department of Respiratory and Critical Care Medicine has rich experience in the diagnosis and treatment of difficult cases. As the last stop for patients to trust their lives, Peking Union Medical College Hospital has always actively sought the best treatment plan for difficult and serious diseases, performed benevolent techniques with benevolence, achieved great doctors with great love, and adhered to the mission of protecting the people's health.
Text/Wang Jingxia
Photo/ Courtesy of the Department of Respiratory and Critical Care Medicine
Editor/Wang Jingxia
Editor-in-Chief/Chen Mingyan
Producer/Wu Peixin