RT Book, Section A1 Wong, David T. A2 Hung, Orlando A2 Murphy, Michael F. SR Print(0) ID 55870222 T1 Chapter 30. Management of a Patient Admitted to the ICU with Impending Respiratory Failure Due to a Suspected Infectious Etiology T2 Management of the Difficult and Failed Airway, 2e YR 2012 FD 2012 PB The McGraw-Hill Companies PP New York, NY SN 978-0-07-162344-5 LK accessanesthesiology.mhmedical.com/content.aspx?aid=55870222 RD 2024/03/29 AB A 47-year-old previously healthy male physician presented to hospital with the acute onset of fever, nonproductive cough, dyspnea, and malaise. As an intensive care unit (ICU) physician, he had intubated the trachea of a known Severe Acute Respiratory syndrome (SARS) patient in the emergency department 2 weeks earlier. He began to have respiratory symptoms 1 week later. He was admitted and placed in an isolation room. Both sputum and blood cultures were negative. In spite of empiric treatment with broad-spectrum antibiotics, his respiratory status progressively worsened over the next 24 hours, necessitating ICU admission. His vitals on admission to the ICU were respiratory rate (RR) 24 breaths per minute, heart rate (HR) 100 beats per minute (bpm), BP 130/90 mm Hg, and temperature 38.6°C. Oxygen saturation was 95% on an FiO2 of 60%, and arterial blood gases (ABGs) revealed the following: pH 7.45, PCO2 30, PO2 60. With the PO2 to FiO2 ratio (PF ratio) determined to be 100, respiratory failure was diagnosed. The chest x-ray (CXR) showed progressive bilateral basal infiltrates. A complete blood count, electrolytes, creatinine, and liver function tests were all normal, but LDH was elevated. Neurological and cardiovascular systems were intact on examination.