[Preliminary analysis of treatment in 32 patients with critical severe acute respiratory syndrome].

Lu, Wei; Zhang, Hong-sheng; Wang, Feng-mei; Wang, Shao-jun; Wu, Xiao-di; Zhang, Na-xin; Kan, Zhi-chao; Qin, Ying-zhi; Xiao, Lang

OBJECTIVE To summarize the experience of treatment in 32 critical severe acute respiratory syndrome (SARS) patients. METHODS The age of 32 patients ranged from 19 to 72 years, the average was 43.06 years. Among them, 13 patients were having serious primary diseases, i.e. cardio-cerebral-vascular disease in 9 patients, diabetes in 2 patients, renal dysfunction in 1 patient, and chronic obstructive pulmonary disease (COPD) in 1 patient. The treatment included antiviral agents, glucocorticoid, mechanical ventilation, antibiotics and immunologic enhancement, etc. Cure rate, mortality and complications were analyzed. RESULTS Among 32 patients, 24 were cured, 2 died of respiratory failure, 6 died of their primary diseases, and the overall mortality was 25.00 percent. Superimposed infection occurred in 12 patients, and among 17 patients who required noninvasive ventilation, 3 patients were complicated by lung injury (mediastinal emphysema, pneumothorax). In addition, hyperglycemia was found in 4 patients, upper intestinal hemorrhage occurred in another 4 patients and cardiac failure occurred in 6 patients. CONCLUSION The treatment of the pre-existing diseases should be emphasized in the treatment of critical SARS. Glucocorticoid should not be used for a long-term. Vigilance should be paid to avoid lung injury during mechanical ventilation.