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Excellent Recovery In Type II Respiratory Failure

Case Study | Excellent recovery in type II respiratory failure - VishwaRaj Hospital
Case Scenario

45 Yrs / Female, K/C/O HTN admitted with complaints of Breathlessness since 3 to 4 Days, Fever since 1 Day, Generalized Weakness & Pedal Oedema since 3 Days. Admitted outside and received Primary Treatment. Increased Breathlessness, desaturating during hospitalisation hence shifted to VishwaRaj Hospital at midnight 1 am. Patient received at emergency room with Tachypnea, Tachycardia and Desaturation. Bilateral wheezing present on auscultation. Primary management done at ER with Oxygen therapy by face mask. All required investigation such as X-Ray, ABG, Lab tests were done.

Great Efforts

Management at ICU – 

  • ABG S/O Severe Respiratory Acidosis (Type II Respiratory Failure)
  • Patient was unable to maintain Oxygen saturation with high ow oxygen hence was taken on Non Invasive Ventilator – BIPAP.
  • After 2 Hrs, Patient is in Persistent Respiratory Acidosis & became Drowsy with increased tachypnea and tachycardia.
  • In view of Co2 narcosis patient intubated and taken on invasive ventilation.
  • Neuro Physician opinion taken for drowsiness.
  • Post Intubation ABG done after 4 Hrs. Suggestive of Resolving Respiratory Acidosis.
  • Patient ventilated for 24 Hrs.
  • After ensuring hemodynamic stability and resolving acidosis patient was extubated on day 2nd.
  • Patient was taken on Elective BIPAP.
  • ABG improved on Day 3rd ( PH – 7.43, PCo2 – 52, Po2 – 93, Hco3 – 33.9, LACT – 0.74 on 35% fio2 ) off NIV trial was given.
Excellent Recovery
Interventions that makes the difference

1. Early Identification of Type II Respiratory Failure.
2. Effective Utilization of NIV.
3. Vigilant “Respiratory & Neuro Monitoring” during NIV.
4. Avoid Delay in Intubation.
5. Post Extubation NIV.

After 24 hrs of NIV trial, chest cleared, maintaining saturation on oxygen and hemodynamic stability patient shifted to ward on Day 05 for further management and was discharged with full recovery on Day 07.
Treating Doctors –
Dr Kapil Borawake
MBBS, DNB, IDCCM Director – ICU & Medicine
Dr Vijay Khandale
Dr Sushant Shinde
Dr Sushant Shinde
MBBS, DNB IDCCM PGD DIABETES Consultant – Medicine
Dr Sanesh Garde
Dr Sanesh Garde
MBBS, DTCD Consultant – Pulmonologist
Dr Mahabal Shah
MBBS, DNB (MED), DNB (NEURO) Consultant – Neuro Physician
Dr Subhash Auti
MBBS, MD (Ane), IDCCM Consultant – ICU
Our Anesthesia Team –

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    Department Of ICU
    Intensive Care Unit department provides life support and critical care in serious cases. At VishwaRaj Hospital, our special team of doctors in this department are well trained to assess and analyse the patient’s clinical condition and come up with possible clinical treatment options available in the least time.
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