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Volume 351:105-106 July 1, 2004 Number 1
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Case 9-2004: An 18-Year-Old Man with Respiratory Symptoms and Shock

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 by Gerberding, J. L.
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To the Editor: In the case of influenza presented by Todres and discussed by Gerberding et al. (March 18 issue),1 there are two points that need further examination. First, the obese patient had received at least 20 liters of fluid in 32 hours before he died from unremitting shock, yet no mention is made of measurement of the intraabdominal pressure. There is a growing body of evidence that suggests that the body-mass index and massive fluid resuscitation are the main independent causes of intraabdominal hypertension.2,3

Second, the patient received hydrocortisone after he was found to have a baseline cortisol level . . . [Full Text of this Article]




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