A Man in his 80s With Refractory Hypoxia and Shock Postcardiac Arrest

摘要

A man in his 80s was brought to the ED for fever, productive cough, and respiratory distress for 3?days. He has a medical history of advanced dementia, active metastatic prostate cancer, and recurrent aspiration; he has been living in a nursing home for the past 5 years.In the ED, the patient was normotensive with a heart rate of 80 beats/min and an oxygen saturation of 94%?while breathing 2 L/min of oxygen via nasal cannula. His breathing was labored and rapid, with the chest auscultation revealing coarse crackles in the left lower lung field. A chest radiograph showed left lower lobe dense opacification, consistent with a diagnosis of pneumonia. He was intubated in the ED due to worsening respiratory status and was admitted to the ICU. He was stabilized temporarily with minimal ventilator support (F