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患者，男，45岁，干部。因服用“胎盘粉”呛咳后持续哮喘48小时而住呼吸内科，治疗8小时无缓解转ICU。查体见：全身发绀，呼吸急促48次/分，呈明显三凹征，桶状胸，叩诊为鼓音，双肺广泛哮鸣音及少许湿啰音，心率126次/分。除积极抗感染外，给予氢化可的松800毫克/日，β_2受体兴奋剂雾化吸入及氨茶碱静脉滴注血药浓度达12～16μg/ml（应用血药浓度为10～20μg/ml）病情无好转，发绀加重，神志恍惚，心率达140次/分。动脉血气：pH7.26～7.36，PCO_27.6～9.1kPa（56.9～68.4mmHg），PO_23.7～4.0kPa（28.5～30mmHg），SatO_20.50～0.70，HCO_3~-27.3～32.3mmol/L，床旁胸片除外气胸，立即给予气管插管，用琥珀胆碱打掉患者急促无效的自主呼吸，并以20μg
Patient, male, 45 years old, cadre. Due to taking “placental powder” cough continued asthma 48 hours and living respiration medicine, 8 hours of treatment without ICU. Physical examination found: the whole body cyanosis, shortness of breath 48 times / min, showed obvious three concave sign, barrel chest, percussion drum sounds, extensive lung wheezing lungs and a little wet rales, heart rate 126 beats / min. In addition to active anti-infection, given hydrocortisone 800 mg / day, β 2 receptor agonist inhalation and intravenous aminophylline plasma concentration of 12 ~ 16μg / ml (application of plasma concentration of 10 ~ 20μg / ml) did not improve the condition, cyanosis increased, trance, heart rate up to 140 beats / min. Arterial blood gas: pH7.26-7.36, PCO27.6-9.1kPa (56.9-68.4mmHg), PO23.7-4.0kPa (28.5-30mmHg), SatO20.50-0.70, HCO3-2.7.3-32.3 mmol / L, Bedside chest except pneumothorax, immediately given tracheal intubation, with succinylcholine destroyed patients with rapid spontaneous breathing ineffective, and 20μg