Acute respiratory distress syndrome following multiple wasp stings treated with extracorporeal membrane oxygenation:A case report  

作　　者：Zheng-Yin Cai Bao-Ping Xu Wei-Hao Zhang Huai-Wen Peng Qing Xu Huai-Bin Yu Quan-Gen Chu Shu-Sheng Zhou 

机构地区：[1]Department of Critical Care Medicine,Traditional Chinese Hospital of Lu'an Affiliated to Anhui University of Traditional Chinese Medicine,Lu'an 237000,Anhui Province,China [2]Department of Chinese Medicine,Anhui University of Traditional Chinese Medicine,Hefei 230031,Anhui Province,China [3]Department of Intensive Care Unit,The First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,Anhui Province,China

出　　处：《World Journal of Clinical Cases》2022年第30期11122-11127,共6页世界临床病例杂志

摘　　要：BACKGROUND It is necessary for clinicians to be aware of a rare but possible acute respiratory distress syndrome(ARDS)complication caused by multiple wasp stings.Severe ARDS has a high mortality rate but no specific pharmacotherapies have been identified to date.This case study presents the first case of severe ARDS caused by multiple wasp stings,treated successfully with extracorporeal membrane oxygenation(ECMO).It also emphasizes the effectiveness of early ECMO treatment for severe ARDS with persistent hypoxemia.CASE SUMMARY A 24-year-old woman was admitted to the emergency department after being stung by more than 10 wasps within a 30-min period,with clinical symptoms of multiple rashes,dizziness,chest tightness,nausea,and vomiting.On the 2nd day of admission,the patient developed progressive dyspnea.The patient was diagnosed with ARDS based on clinical manifestations and lung computed tomography(CT)scan.Because of the progressive dyspnea,the intensive care unit physician performed endotracheal intubation and continued to provide ventilator support,but the patient’s respiratory distress worsened,as indicated by the ratio of arterial partial pressure of oxygen to fraction of inspired oxygen.Veno-venous ECMO was initiated for 6 d.On day 7 of admission,ECMO was stopped.On the 11th day of admission,CT scan of the lungs revealed significant reduction of ground-glass opacities and consolidations.After about 2 wk,the patient recovered completely from ARDS and was discharged to home.At the 2-mo follow-up,the patient was in good health with no recurrence of dyspnea nor chest tightness.CONCLUSION ARDS complication caused by multiple wasp stings may be fatal when mechanical ventilation becomes dangerous due to persistent hypoxemia and despite optimization of ARDS management.We propose that the early implementation of ECMO is a relatively effective treatment,although the evidence is relatively limited.

关 键 词：WASP Bites and stings Respiratory distress syndrome Persistent hypoxemia Extracorporeal membrane oxygenation Case report 

分 类 号：R563.8[医药卫生—呼吸系统] R646[医药卫生—内科学]