Adult respiratory distress syndrome after radical neck dissection

Abstract

Accepted for publication 28th April, 1993. fection, developed ARDS a few hours after surgery, probably due to sepsis. Case reportA 72-yr-old patient was scheduled for radical neck dissection to excise a metastatic neck tumour. Two months earlier, he underwent total laryngectomy for a squamous cell carcinoma of the larynx. He had a history of heavy smoking and alcoholism. At the preanaesthetic examination, the patient, fitted with a permanent metallic tracheostomy cannula, appeared to be in good condition. The physical examination was normal, his rectal temperature was 36.5~ and the laboratory data were within normal limits. A chest x-ray revealed emphysema.On arrival at the operating room, he felt well and with vital signs within normal limits. A catheter (AL) was introduced into the left radial artery and a central venous line into the left basilic vein.After substituting the permanent tracheostomy cannula with a flexible Ruschlit tracheostomy tube (Rush, Germany), anaesthesia was induced with midazolam (3 rag), fentanyl (0.01 mg-kg-l), followed by boluses (0.002-0.003 mg. kg -l) as needed, and pancuronium (0.

ARDS and sepsis — definitions and new therapy

“…En dtpit d'une meilleure comprthension de la physiopathologie, la mortalit6 de I'ARDS du hun sepsis demeure entre 40 et 70%. 7 Dans cette 4dition du Journal, le cas d'un homme de 72 ans qui a dtvelopp6 une dttresse respiratoire stv~re avec hypoxtmie en ptriode post-optratoire immediate, est dtcrit par Ezri et al 8 Cet ARDS (du fi une bacttritmie et ~ un sepsis) a rendu difficile le sevrage ventilatoire apr~s une dissection radicale du cou. L'hypox-6mie et l'atteinte pulmonaire aigiie assocites rtgresstrent rapidement sous thtrapeutique de support car la cause du sepsis fut supprimte rapidement.…”