RT Journal Article
SR Electronic
T1 Prone ventilation in a pregnant patient with scrub typhus-induced acute respiratory distress syndrome
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e242870
DO 10.1136/bcr-2021-242870
VO 14
IS 4
A1 Meenupriya Arasu
A1 Nagalakshmi Swaminathan
A1 Anusha Cherian
A1 Magesh Parthiban
YR 2021
UL http://casereports.bmj.com/content/14/4/e242870.abstract
AB A 23-year-old primigravida at 20 weeks of gestation presented to our hospital with undifferentiated febrile illness and severe acute respiratory distress syndrome. She was intubated in the emergency department and transferred to the intensive care unit. Initial treatment included ventilatory care, vasopressor support and broad-spectrum antibiotics. Based on a positive PCR assay for scrub typhus, she was treated with intravenous doxycycline and azithromycin. Despite reduction in fever, her oxygenation further declined. Following a risk–benefits assessment, we decided to ventilate her in prone position for 8 hours a day for three consecutive days using a checklist-based protocol. Her oxygenation indices and lung compliance markedly improved over this period, and she was extubated a day later. She was eventually discharged home after 1 week.