NNT patient (49 years old) was admitted to the hospital at noon on 11/5 in a state of lethargy, impaired consciousness with a history of type 2 diabetes, alcohol abuse.
About 4 days before admission, the patient ate poorly, drank a lot of alcohol with fever, had loose stools 3-4 times a day. At noon on 11/5, the patient’s family discovered that the patient was in a state of lethargy and called to ask no response.
The patient was admitted to the Emergency Department, Duc Giang General Hospital in a state of rapid pulse 110 times/minute; Blood pressure drops 60/40mmHg; SpO2 80%, rapid breathing 30 times/min.
Immediately after, the patient was intubated by the doctor, breathing with balloons, infusion, high-dose vasopressors and performed the necessary paraclinical indications. The patient was transferred to the Intensive Care Unit – Anti-toxic in the state of sedation, balloon breathing, pulse 110 times/minute, blood pressure 90/60mmHg (using vasopressor dose of 0.8ug/kg/p), SpO2 98%.
Tests showed severe acidosis (pH 6.9, HCO3 4.3), very severe infections (pro-calcitonin 42.1ng/mL) and multiple organ failure (Urea/crea 26/318 mmol/L). . Especially this person’s blood potassium is very high 7.5mmol/L. The prognosis is very serious, the risk of death is high.
The patient was quickly assessed by the doctors of the Intensive Care Department – Anti-toxicity as a state of septic shock, organ failure, treated with alkaline and isotonic fluids, maintaining high doses of vasopressors, taking antibiotics in combination. , diuretics, invasive mechanical ventilation.
However, patients responded poorly, blood pressure improved slowly and no urine. The prognosis of Mr. T.’s condition is very critical. If not treated, timely intervention can be life-threatening. The patient was quickly consulted and underwent continuous dialysis.
After 8 h of hemodialysis, the patient’s acid-base status improved (pH 7.3 HCO3 16), vasomotor was stopped, and urine production started. After 2 days of treatment, the 49-year-old man was extubated, his infection decreased, and hemodynamically stable.
After 5 days of treatment, the patient had no fever, no loose stools, stable hemodynamics, stable blood sugar control, and deep infection.
Doctors recommend that excessive use of alcohol increases health risks, especially the liver will be overloaded, reducing its ability to filter out toxic substances, causing the body to accumulate chemicals. poisoned. Alcohol also causes serious damage to the nerves, heart …
Danger signs that need to be differentiated and treated immediately are: coma (called unconsciousness), convulsions; respiratory failure (slow breathing; respiratory arrest; sputum stagnation; vomit, gastric juice reflux into the lungs because the comatose patient no longer has respiratory protective reflexes…), circulatory failure (hemorrhage). pressure, not able to catch pulse, bradycardia, arrhythmia…) and other dangerous signs such as hypoglycemia, trauma…
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