A rare clinical case of household gas leak leading to severe asphixia

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Abstract

A rare case of severe asphyxia in a young patient due to household gas leakage WAS presented. The patient was found in an unconscious state with signs of respiratory failure at home, requiring respiratory support at the prehospital stage. The patient had a picture of damage to the circulatory organs with the development of acute myocardial ischemia without damage and reactive hydropericardium, respiratory organs in the form of hypoxic pulmonary edema, complicated by the development of bilateral community-acquired pneumonia, hydrothorax and severe respiratory failure, damage to the nervous system with the development of hypoxic encephalopathy with loss of consciousness and bilateral pyramidal syndrome, digestive organs with the development of reactive posthypoxic hepatopathy. Upon admission to the clinic of the field therapy of the Military Medical Academy of S.M. Kirov, which required hospitalization of the patient in the intensive care unit. It was possible to fully stop severe multiple organ damage that developed as a result of acute hypoxic exposure as a result of the complex treatment. This clinical case clearly demonstrates the importance of emergency, systematic and full-fledged intensive care at all stages of providing care to people with acute hypoxic lesions of organs and systems, including severe community-acquired pneumonia and hypoxic myocardial dystrophy. The influence of the early intensive care initiation and timely evacuation at the stage of qualified and specialized medical care on the effectiveness of therapeutic measures is discussed as this plays a fundamental role in the survival of this category of patients. In general, with timely and full-fledged therapeutic measure implementation aimed at treating complications, even severe acute hypoxic organs lesions and systems are reversible, although this may require long-term inpatient treatment and rehabilitation measures in a military sanatorium-resort organization condition of a therapeutic profile, as well as conducting a military medical examination to establish the fitness category for further military service.

About the authors

Evgeniy V. Kryukov

Military Medical Academy of S.M. Kirov

Email: evgeniy.md@mail.ru
ORCID iD: 0000-0002-8396-1936
SPIN-code: 3900-3441
Scopus Author ID: 57208311867
ResearcherId: AAO-9491-2020

Doctor of Medical Sciences, Professor

Russian Federation, Saint Petersburg

Sergey V. Gaiduk

Military Medical Academy of S.M. Kirov

Email: gaiduksergey@mail.ru
ORCID iD: 0000-0003-1524-9493
SPIN-code: 8602-4922

Doctor of Medical Sciences, Associate Professor

Russian Federation, Saint Petersburg

Yuriy B. Goverdovskiy

Military Medical Academy of S.M. Kirov

Email: goverdoc@yandex.ru
ORCID iD: 0000-0003-1241-9725
SPIN-code: 2605-7097

Doctor of Medical Sciences

Russian Federation, Saint Petersburg

Vladimir G. Kuzmich

Military Medical Academy of S.M. Kirov

Email: q-zmich1978@mail.ru
ORCID iD: 0000-0001-7754-3634
SPIN-code: 7135-6357

Candidate of Medical Sciences

Russian Federation, Saint Petersburg

Alexey B. Bogomolov

Military Medical Academy of S.M. Kirov

Email: Bg-ab@mail.ru
ORCID iD: 0000-0002-6110-1097
SPIN-code: 4175-2774

Candidate of Medical Sciences

Russian Federation, Saint Petersburg

Ilya D. Shapovalov

Military Medical Academy of S.M. Kirov

Author for correspondence.
Email: ilshapovalov@yandex.ru
ORCID iD: 0000-0001-7986-3359
SPIN-code: 9775-9491

Adjunct

Russian Federation, Saint Petersburg

Alexey A. Mihailov

Military Medical Academy of S.M. Kirov

Email: auri8@mail.ru
ORCID iD: 0000-0001-5656-2764
SPIN-code: 3957-6107

Adjunct

Russian Federation, Saint Petersburg

Timofey V. Lyanginen

Military Medical Academy of S.M. Kirov

Email: finn_off@mail.ru
ORCID iD: 0000-0003-3816-9242
SPIN-code: 3494-6532

Candidate of Medical Sciences

Russian Federation, Saint Petersburg

Stanislav S. Vlasov

Military Medical Academy of S.M. Kirov

Email: vlasovstass@mail.ru
ORCID iD: 0000-0003-3407-1096

Candidate of Medical Sciences

Russian Federation, Saint Petersburg

Artem A. Ivanov

Branch № 4 of the 419nd Military clinical hospital

Email: rusfanstar@mail.ru
ORCID iD: 0000-0003-1009-6096

Resident

Russian Federation, Anapa

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Supplementary files

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1. JATS XML
2. Fig. 1. Dynamics of indicators of clinical blood analysis

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3. Fig. 2. Dynamics of some indicators of biochemical blood analysis

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4. Fig. 3. Dynamics of some indicators of biochemical blood analysis

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5. Fig. 4. CT at admission (02.11.2021). Arrows indicate signs of draining alveolar infiltration of lung tissue with predominant volume in the posterior basal sections of both lungs

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6. Fig. 5. Electrocardiogram at hospital admission. Changes in repolarization processes in the I and aVL leads, a small horizontal ST segment depression with T wave inversion are indicated

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7. Fig. 6. ECG on the 9th day of treatment. A variant of the norm without pathological changes

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8. Fig. 7. CT from 11.15.2021. Resolution of signs of alveolar infiltration of the pulmonary parenchyma

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Copyright (c) 2022 Kryukov E.V., Gaiduk S.V., Goverdovskiy Y.B., Kuzmich V.G., Bogomolov A.B., Shapovalov I.D., Mihailov A.A., Lyanginen T.V., Vlasov S.S., Ivanov A.A.

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