Objective To explore the clinical characteristics and causes of misdiagnosis of perioperative acute lung injury(PALI).Methods The clinical data of 5 patients with PALI admitted from January 2018 to December 2023 were ret-rospectively analyzed.Results Different degrees of PALI occurred in 5 patients during operation.Among them,4 patients had hypoxemia,sinus tachycardia,ST segment depression,and increased airway pressure as the initial symptoms(2.5-3.0 h after the operation),and were initially misdiagnosed as acute cardiac insufficiency.The main manifestations of a patient un-dergoing radical resection for thoracoesophageal cancer were coughing and total endotracheal hemorrhage in the right double-lumen bronchial catheter during the recovery period,which was initially misdiagnosed as airway injury.The duration of misdi-agnosis of 5 patients was 15-40 min.After multidisciplinary consultation,comprehensive analysis of clinical manifestations,combined with the imaging features of increased lung texture disorder,increased lung water,and preoperative related co-existing diseases,the diagnosis was clear.After diagnosis,glucocorticoid anti-inflammatory and antibiotics were used to pre-vent infection,control fluid intake,diuresis to reduce cardiopulmonary load and edema,supplement colloidal fluid and albu-min to enhance colloid osmotic pressure and promote interstitial fluid return,and the recovery was good.Conclusion PALI lacks specific biomarkers and typical clinical signs,making it prone to misdiagnosis and mistreatment in the process of diagno-sis and treatment.Clinicians should enhance their vigilance towards such diseases and conduct targeted education and training to effectively avoid clinical misdiagnosis.
维普
万方数据