42 year old alcoholic in ICU for severe pancreatitis. ABG - ph - 7.39, Pco2 - 43mm Hg, PO2- 86 mmHg. Increased PEEP requirement and Fio2 - 50%. Xray shown below. Your views

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It is a case of septecemia due to Pancreatitis resulting in bilateral basal & midzones of lungs.Rx As there is ARDS it is ideal to put him on appropriate Antibiotic & Ventilator support Antibiotics preferably Inj. Meripanam IV, Oflomox oz tid,& supportive therapy ie IV fluids vitamins etc
ARDS.
Alcoholic Pancreatitis with ARDS( Metabolic Acidosis) Treated with B_lactamase inhibitor or anti pseudomonal carbepenem group agents or antipeudomonal fluoroquinolene plus aminoglycoside Supportive treatment
Could be vap venti associated pneumonia, compare with previous xray. Venti settings are ok. If VAP chage ET Tube take all septic precautions and upgrade antibiotics prefer carbepenum.
A. R. D. S with extensive pulmonary edema, with of course hypoxia decreased function ing lung. Needs assisted ventilation with ICU monitoring
ARDS.. Needs oxygen support and antibiotics after c.s.test And broncho dialeters and corticosteroids if needed
institute bilateral flank drains to drain toxic fuid from pertoneal cavity. this may improve lung condtion.
Ards or may be its H1N1 kindly give them temifru with higer antibiotics
Ards acidosis cardiomegaly do hrct rt dome of diaphragm raised
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