Use of High-Flow Nasal Cannula Oxygen Therapy in a Pregnant Woman with Dermatomyositis-Related Interstitial Pneumonia
A 33-year-old pregnant woman was referred to our hospital with respiratory distress at 30 weeks of gestation. Chest computed tomography (CT) scans revealed pulmonary infiltrates along the bronchovascular bundles and ground-glass opacities in both lungs. Despite immediate treatment with steroid pulse...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2017-01-01
|
| Series: | Case Reports in Critical Care |
| Online Access: | http://dx.doi.org/10.1155/2017/4527597 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832549036661407744 |
|---|---|
| author | Tomohiro Shoji Takeshi Umegaki Kota Nishimoto Natsuki Anada Akiko Ando Takeo Uba Munenori Kusunoki Kanako Oku Takahiko Kamibayashi |
| author_facet | Tomohiro Shoji Takeshi Umegaki Kota Nishimoto Natsuki Anada Akiko Ando Takeo Uba Munenori Kusunoki Kanako Oku Takahiko Kamibayashi |
| author_sort | Tomohiro Shoji |
| collection | DOAJ |
| description | A 33-year-old pregnant woman was referred to our hospital with respiratory distress at 30 weeks of gestation. Chest computed tomography (CT) scans revealed pulmonary infiltrates along the bronchovascular bundles and ground-glass opacities in both lungs. Despite immediate treatment with steroid pulse therapy for suspected interstitial pneumonia, the patient’s condition worsened. Respiratory distress was slightly alleviated after the initiation of high-flow nasal cannula (HFNC) oxygen therapy (40 L/min, FiO2 40%). We suspected clinically amyopathic dermatomyositis (CADM) complicating rapidly progressive refractory interstitial pneumonia. In order to save the life of the patient, the use of combination therapy with immunosuppressants was necessary. The patient underwent emergency cesarean section and was immediately treated with immunosuppressants while continuing HFNC oxygen therapy. The neonate was treated in the neonatal intensive care unit. The patient’s condition improved after 7 days of hospitalization; by this time, she was positive for myositis-specific autoantibodies and was diagnosed with interstitial pneumonia preceding dermatomyositis. This condition can be potentially fatal within a few months of onset and therefore requires early combination immunosuppressive therapy. This case demonstrates the usefulness of HFNC oxygen therapy for respiratory management as it negates the need for intubation and allows for various treatments to be quickly performed. |
| format | Article |
| id | doaj-art-70e4d09e5e3f422b841d74ae2ede5c7a |
| institution | Kabale University |
| issn | 2090-6420 2090-6439 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Critical Care |
| spelling | doaj-art-70e4d09e5e3f422b841d74ae2ede5c7a2025-02-03T06:12:18ZengWileyCase Reports in Critical Care2090-64202090-64392017-01-01201710.1155/2017/45275974527597Use of High-Flow Nasal Cannula Oxygen Therapy in a Pregnant Woman with Dermatomyositis-Related Interstitial PneumoniaTomohiro Shoji0Takeshi Umegaki1Kota Nishimoto2Natsuki Anada3Akiko Ando4Takeo Uba5Munenori Kusunoki6Kanako Oku7Takahiko Kamibayashi8Department of Anesthesiology, Kansai Medical University Hospital, Osaka, JapanDepartment of Anesthesiology, Kansai Medical University Hospital, Osaka, JapanDepartment of Anesthesiology, Kansai Medical University Hospital, Osaka, JapanDepartment of Anesthesiology, Kansai Medical University Hospital, Osaka, JapanDepartment of Anesthesiology, Kansai Medical University Hospital, Osaka, JapanDepartment of Anesthesiology, Kansai Medical University Hospital, Osaka, JapanDepartment of Anesthesiology, Kansai Medical University Hospital, Osaka, JapanDepartment of Anesthesiology, Kansai Medical University Hospital, Osaka, JapanDepartment of Anesthesiology, Kansai Medical University Hospital, Osaka, JapanA 33-year-old pregnant woman was referred to our hospital with respiratory distress at 30 weeks of gestation. Chest computed tomography (CT) scans revealed pulmonary infiltrates along the bronchovascular bundles and ground-glass opacities in both lungs. Despite immediate treatment with steroid pulse therapy for suspected interstitial pneumonia, the patient’s condition worsened. Respiratory distress was slightly alleviated after the initiation of high-flow nasal cannula (HFNC) oxygen therapy (40 L/min, FiO2 40%). We suspected clinically amyopathic dermatomyositis (CADM) complicating rapidly progressive refractory interstitial pneumonia. In order to save the life of the patient, the use of combination therapy with immunosuppressants was necessary. The patient underwent emergency cesarean section and was immediately treated with immunosuppressants while continuing HFNC oxygen therapy. The neonate was treated in the neonatal intensive care unit. The patient’s condition improved after 7 days of hospitalization; by this time, she was positive for myositis-specific autoantibodies and was diagnosed with interstitial pneumonia preceding dermatomyositis. This condition can be potentially fatal within a few months of onset and therefore requires early combination immunosuppressive therapy. This case demonstrates the usefulness of HFNC oxygen therapy for respiratory management as it negates the need for intubation and allows for various treatments to be quickly performed.http://dx.doi.org/10.1155/2017/4527597 |
| spellingShingle | Tomohiro Shoji Takeshi Umegaki Kota Nishimoto Natsuki Anada Akiko Ando Takeo Uba Munenori Kusunoki Kanako Oku Takahiko Kamibayashi Use of High-Flow Nasal Cannula Oxygen Therapy in a Pregnant Woman with Dermatomyositis-Related Interstitial Pneumonia Case Reports in Critical Care |
| title | Use of High-Flow Nasal Cannula Oxygen Therapy in a Pregnant Woman with Dermatomyositis-Related Interstitial Pneumonia |
| title_full | Use of High-Flow Nasal Cannula Oxygen Therapy in a Pregnant Woman with Dermatomyositis-Related Interstitial Pneumonia |
| title_fullStr | Use of High-Flow Nasal Cannula Oxygen Therapy in a Pregnant Woman with Dermatomyositis-Related Interstitial Pneumonia |
| title_full_unstemmed | Use of High-Flow Nasal Cannula Oxygen Therapy in a Pregnant Woman with Dermatomyositis-Related Interstitial Pneumonia |
| title_short | Use of High-Flow Nasal Cannula Oxygen Therapy in a Pregnant Woman with Dermatomyositis-Related Interstitial Pneumonia |
| title_sort | use of high flow nasal cannula oxygen therapy in a pregnant woman with dermatomyositis related interstitial pneumonia |
| url | http://dx.doi.org/10.1155/2017/4527597 |
| work_keys_str_mv | AT tomohiroshoji useofhighflownasalcannulaoxygentherapyinapregnantwomanwithdermatomyositisrelatedinterstitialpneumonia AT takeshiumegaki useofhighflownasalcannulaoxygentherapyinapregnantwomanwithdermatomyositisrelatedinterstitialpneumonia AT kotanishimoto useofhighflownasalcannulaoxygentherapyinapregnantwomanwithdermatomyositisrelatedinterstitialpneumonia AT natsukianada useofhighflownasalcannulaoxygentherapyinapregnantwomanwithdermatomyositisrelatedinterstitialpneumonia AT akikoando useofhighflownasalcannulaoxygentherapyinapregnantwomanwithdermatomyositisrelatedinterstitialpneumonia AT takeouba useofhighflownasalcannulaoxygentherapyinapregnantwomanwithdermatomyositisrelatedinterstitialpneumonia AT munenorikusunoki useofhighflownasalcannulaoxygentherapyinapregnantwomanwithdermatomyositisrelatedinterstitialpneumonia AT kanakooku useofhighflownasalcannulaoxygentherapyinapregnantwomanwithdermatomyositisrelatedinterstitialpneumonia AT takahikokamibayashi useofhighflownasalcannulaoxygentherapyinapregnantwomanwithdermatomyositisrelatedinterstitialpneumonia |