2018, Number 2
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Med Crit 2018; 32 (2)
Diagnóstico ultrassonográfico da insuficiência respiratória aguda pós-operatória após timectomia
Catalá RJV, Carrió FM, Cuesta MP, Torres VC, Simón PE, Monsalve NJÁ
Language: Spanish
References: 10
Page: 108-110
PDF size: 150.78 Kb.
ABSTRACT
Myasthenia gravis is an autoimmune disease that can alter the physical abilities of patients. Thymectomy is one of the therapeutic options. The postoperatory may be complicated by the disease itself or by intraoperative lesions of nerve structures. Case of 66-year-old woman with myasthenia gravis undergoing thymectomy. The left phrenic nerve was resected. In the immediate postoperative period, the patient presented acute respiratory failure. A lung ultrasound is performed, being anodyne. The diaphragmatic ultrasound proved a 10% of thickening fraction on the right side and absence of contractility on the left side. The patient required non-invasive mechanical ventilation for six days, tracheotomy was performed to succeed the respiratory weaning. The patient was transferred to ward in spontaneous ventilation. The diaphragmatic ultrasound is a useful and portable diagnostic technique, mainly in urgent situations due to the rapidity of its implementation. It complements the clinical assessment in the diagnosis of acute postoperative respiratory failure.
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