Weaning Difficulty in Patient with End Stage Renal Disease Acute with Respiratory Failure due to Pulmonary Edema and Pneumonia

Primta Bangun, Suwarman Suwarman
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Abstract

Introduction: End Stage Renal Disease (ESRD) 5D patient have potential to respiratory failure due to excess fluid, thus increasing the incidence of repeated hospital admissions. Deaths were reported in about 15%– 30% cases, where 50%–60% of patients needed respiratory support with mechanical ventilation. About 30%– 40% of patients had complications in the weaning process from mechanical ventilation. Prolonged mechanical ventilation increased mortality and morbidity, the length of stay periods and costs. Case Report: This case report will discuss the difficult weaning from mechanical ventilation in patients with ESRD 5D who have respiratory failure due to edema pulmonary and pneumonia who were hospitalized at the Intensive Care Unit (ICU) of Hasan Sadikin Hospital - Bandung for 20 days Conclusion: Weaning difficulty due to accumulation positive fluid balance during hospitalization lead to longer use of mechanical ventilation and pulmonary infection get heavier. A positive cumulative fluid balance could be one factor of weaning difficulty
终末期肾病急性肺水肿及肺炎合并呼吸衰竭患者的脱机困难
终末期肾病(ESRD) 5D患者有可能因体液过多而发生呼吸衰竭,从而增加了反复住院的发生率。约有15% - 30%的病例报告死亡,其中50%-60%的患者需要机械通气的呼吸支持。约30% - 40%的患者在机械通气脱机过程中出现并发症。延长机械通气时间增加了死亡率和发病率、住院时间和费用。病例报告:本病例报告将讨论在万隆Hasan Sadikin医院重症监护室(ICU)住院20天的ESRD 5D合并肺水肿和肺炎呼吸衰竭患者的机械通气困难。结论:住院期间积存的体液阳性平衡导致的脱机困难导致机械通气使用时间延长,肺部感染加重。正的累积体液平衡可能是断奶困难的一个因素
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