Patient in ICU with COVID pneumonia

This patient was admitted to the ICU with COVID pneumonia a few weeks ago and due to a very high D-dimer level, empiric anticoagulation was initiated. The night prior to extubation, the patient's oxygen saturation plummeted, fresh blood appeared in the ventilator tubing, and the second X-ray was obtained.

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Bilateral pneumonitis.deterioration possibly due to pulmonary haemorrhage.
SUGGESTIVE. OF WORSENING. OF COVID. ,19. PNEUMONIA ARDS
B /L Pneumonitis mid & lower zone more on right side ARDS COVID infection
* SEQUENCE OF COVID-19 .. PNEUMONITIS.. * ARDS.. * SARI..
Tnx Dr Sandeep Ghodekar sir..
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* COVID 19 case showing pneumonia and ARDS. 2ND X-RAY DETERIORATING CONDITION MAY LEAD TO EVENTUALITY.
Thanks Dr kute Ankush
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RT ETT Central line in situ. Bil ground glass opacities with nodular infiltration seen. Findings sugg of ARDS. Comparable cxrays are progressively deteriorated.
Progressive versioning clinical status GGOs bilateral 2nd xray shows advancing disease As pt is covid19 positive and D-DIMER raised right step to initiate anticoagulation yes fall out is excessive bleeding or oozing noticed in ventilator tubing Pulmnonary perfusion is compermised and pulmonary oedema increased probably landing in pulmonary thrombosis thence oedema Gcs is 0
Thanx dr Pushkar ji Bhomia
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Bilateral diffuse middle and lower zone pneumonitis
Typical covid pt bilateral pneumonia 2 nd xray infection spread anticoagulation anti inflamatorry steriod antiviral ramsibir antibiotics azithro pt has to sleep on abdomen results positive hcq no pt of rheumatoid died due to covid those on steriod & hcq
Rapid worsening of COVID pneumonia , probably made worse by pulmonary bleeding induced by anticoagulation. What anticoagulation was used ? Suggest continuing ventilation, tranexamic acid. Plasma therapy can be tried .
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