Sudden profound hypoxaemia in the intensive care unit--a case report

Area of Science:

• Critical Care Medicine
• Pulmonology
• Radiology

Background:

• Acute hypoxemia presents a critical emergency, often challenging to diagnose with co-existing lung conditions.
• Pre-existing lung tumors can complicate the differential diagnosis of acute hypoxemia.

Observation:

• A case report details a non-intubated patient with a lung tumor experiencing sudden, profound hypoxemia three days post-abdominal surgery.
• Initial chest X-ray findings suggested airway compression by the tumor, delaying definitive diagnosis.

Findings:

• Emergency computed tomography (CT) imaging identified mucous plugging causing massive atelectasis as the primary cause of hypoxemia.
• This contrasts with initial imaging interpretations that favored tumor-related airway compromise.

Implications:

• Highlights the importance of advanced imaging like CT in diagnosing hypoxemia, especially with complex comorbidities.
• Underscores that mucous plugging leading to atelectasis can mimic other acute airway pathologies in patients with lung tumors.