A case of acute respiratory distress syndrome occurring in a patient with postoperative oral cancer

Abstract

Acute respiratory distress syndrome （ARDS） is the most serious type of respiratory failure, carrying a high mortality rate. We report a case of ARDS occurring postoperatively in a 76-year-old man treated for oral cancer. The patient underwent radical surgery for buccal mucosal cancer. Fibular flap necrosis ensued postoperatively, the site became infected, and ARDS developed. Diffuse bilateral alveolar infiltration was seen on chest radiography. The PaO2/FiO2 ratio fell to 99.1mmHg, even with an oxygen flow of 8l/min delivered by tracheal cannula. He underwent treatment with a ventilator, surgical debridement, and pharmacotherapy. Lung oxygenation raised the PaO2/FiO2 ratio to 203mmHg, and he was weaned from NIPPV 10 days after the onset of symptoms.