Respiratory complication of tsunami victims in Phuket and Phang-Nga

In the present report the authors describe the clinical and laboratory findings of 26 tsunami victims admitted to the Phuket and the Takua Pa Hospital. Patients were classified into 4 groups of severity. class 1, baseline examination negative (n = 1); class 2, baseline examination positive but mechanical ventilation not needed on admission (n = 15); class 3, mechanical ventilation required on admission (n = 9); class 4, cardiopulmonary arrest (n = 1). On admission, 21/23 patients had fever of > 37.5 C. 3/10 patients had hypernatremia and 7/10 cases had metabolic acidosis. The radiological manifestation varied from focal disease to diffuse infiltrations, either reticulonodular or patchy lesions. There were 3 clinical courses among diffuse diseases: 1) diffuse infiltrations and progression 3 cases 2) diffuse infiltration, early regression followed by progression 2 cases 3) diffuse infiltration and steady regression 5 cases. Late complications comprised of pneumothorax/pneumomediastinum (n = 5) and bacterial pneumonia (n = 18). The authors got culture data in 9 patients, most of them were infected with aerobic gram -ve bacteria and 2 of them were B. pseudomallei. The prognosis in the tsunami related medical illness was favorable. Only 2 patients (7.7%) died in the present study.