Current Concepts in Adult Critical Care-Case Presentation and Audience Participation

Video Transcription

All right, so obviously our patient had ARDS, and vitamin C is not a strategy to treat this, as many of you got the answers correct, so.  Our patient is monitored very closely in the ICU, and unfortunately he requires very aggressive therapies for ARDS, including intubation.  Due to the ventilator dyssynchrony that he experiences, he also undergoes a trial of paralysis, and ultimately he requires prone positioning to improve his P to F ratio.  During this period, his bilirubin, AST, and ALT also start to rise. As his lung injury resolves, he no longer requires proning, and the paralytic is weaned off.  However, he has persistently poor mental status, and no longer wakes up during his spontaneous awakening trials.  An altered mental status workup reveals an elevated ammonia level of 153, and a review of his medical history revealed no medications that could have caused his hyperammonemia.  So first question here, which of the following is the most effective way to treat hyperammonemic encephalopathy? If you refresh your page, you should be able to see the question.  All right, we'll give it a couple more seconds for any final takers. The most effective way to treat hyperaminemic encephalopathy.

Video Summary

The video discusses a patient with ARDS receiving aggressive therapies such as intubation and prone positioning in the ICU. The patient experiences ventilator dyssynchrony, leading to a trial of paralysis. As his lung injury improves, he no longer requires prone positioning, and the paralytic is discontinued. However, he continues to have poor mental status and elevated ammonia levels, unrelated to medication. The question posed is about the most effective treatment for hyperammonemic encephalopathy.

Keywords

ARDS

intubation

prone positioning

ventilator dyssynchrony

hyperammonemic encephalopathy

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