Reporte zur Charge ER8727ER8727

Symptomtext

Patient was admitted to Hospital for acute hypoxic respiratory failure secondary to COVID-19 infection and acute kidney injury on 09/05/2021. Patient was started on dexamethasone he was also anticoagulated with heparin given AKI. Acute kidney injury suspected to be prerenal secondary to poor oral intake in the setting of COVID-19 infection patient was also taking several medications at home such as Lasix and lisinopril. Patient required of supplemental oxygenation and fell heated high-flow nasal cannula to refractory hypoxemia then required noninvasive positive pressure ventilation. He continued to become more hypoxic and MRT was called 9/7/21 for hypoxia with oxygen saturation in the 70s and change in mental status. Decision was made to intubate the patient. At this time patient was transferred out of the ICU on mechanical ventilation. He continued to have worsening acute kidney injury and hyperkalemia which point nephrology was consulted and decision was made to start CRRT. Concern for superimposed bacterial infection and patient's antibiotics were escalated to cefepime and vancomycin, no growth on cultures. Patient also required norepinephrine intermittently throughout the admission for hypotension. Patient continued to remain hypoxic despite mechanical ventilation requiring paralytics, proning and was also on nitric oxide. Nitric oxide was stopped and protein was also stop later of the admission due to skin breakdown. Fluid removal per CRRT given concerns for volume overload. Family decided to withdraw care transition to comfort measures only. Patient passed shortly after with family at bedside. Time of death 1435 September 15, 2020