Case of cervical necrotizing fasciitis successfully treated by rapid response system activation

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE
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引用次数: 0

Abstract

Response teams, via the rapid response system (RRS), are activated when a patient's condition deteriorates; respiratory, neurological, or cardiac diseases are precursors to unexpected in-hospital cardiac arrest or death. In December 2019, our hospital introduced the RRS to reduce serious adverse events. Herein, we report a case where RRS was initiated twice for a patient who developed septic shock due to cervical necrotizing fasciitis and non-occlusive mesenteric ischemia (NOMI) after the septic shock. In August 2021, a male in his 70 s developed facial swelling, difficulty opening his mouth, and difficulty with oral intake. We observed necrotic skin on the face, soft tissue swelling in the neck, and hypotension. The RRS was initiated, and the patient was immediately admitted to the intensive care unit (ICU) where he was diagnosed with septic shock and necrotizing fasciitis of the neck. The patient underwent surgical necrotic lesion debridement and incisional drainage under general anesthesia. After weaning from shock, owing to his hypotensive and hemorrhagic status, the RRS was requested again. The patient was re-admitted to the ICU and diagnosed with NOMI. His general condition improved, and he was discharged on day 47.

启动快速反应系统成功治疗颈椎坏死性筋膜炎病例
当患者病情恶化时,响应团队会通过快速响应系统(RRS)启动;呼吸系统、神经系统或心脏疾病是院内意外心脏骤停或死亡的先兆。2019 年 12 月,我院引入了 RRS,以减少严重不良事件的发生。在此,我们报告了一例因颈部坏死性筋膜炎导致脓毒性休克和脓毒性休克后出现非闭塞性肠系膜缺血(NOMI)的患者两次启动 RRS 的病例。2021 年 8 月,一名 70 多岁的男性患者出现面部肿胀、张口困难和进食困难。我们观察到面部皮肤坏死、颈部软组织肿胀和低血压。我们启动了RRS,并立即将患者送入重症监护室(ICU),诊断为脓毒性休克和颈部坏死性筋膜炎。患者在全身麻醉下接受了坏死病灶清创和切口引流手术。从休克状态断奶后,由于血压和出血状况,患者再次要求进行 RRS。患者再次被送入重症监护室,并被诊断为非缺血性休克。他的全身状况有所改善,于第 47 天出院。
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来源期刊
CiteScore
0.80
自引率
0.00%
发文量
129
审稿时长
83 days
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