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Following Breathing Treatments In Hospital Patients Oxygen Levels Dropped Dramatically To 50s What Could Be Issue?

Posted on Thu, 2 Feb 2023

Question: following breathing treatments in hospital patients oxygen levels dropped dramatically . Received treatments for one month in rehab. ,condition declined during this period.Oxygen level was 82 ,breathing treatment was given ,levels began to drop ,patient died when levels fell into 50s. Drop in levels was only noticed in last weeks.

Answered by Dr. Drkaushal85 (31 minutes later)

Brief Answer:
Was patient suffering from underlying lung disease?

Detailed Answer:
Hi,
I am sorry to hear that patient died.
I want to know few more things about patient to guide you further.
Please let me know
1. Was patient suffering from any underlying lung disease like COPD (chronic obstructive Pulmonary disease) or ILD (interstitial lung disease)?
2. Was patient a smoker?
3. What was the age of patient? 33 years?
Breathing treatment if not done correctly or done very vigorously can cause pneumothorax and this can lead to decreasing oxygen saturation, worsening breathing difficulty and ultimately death.
So please let me know answers of above asked questions, so that I can guide you better. I will be happy to help you further.
Thanks.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Drkaushal85 (1 hour later)

patient was 33 year old.Had stoke 3years ago,this affected his cough response. Was on respirator (rehad. purpose was to remove)also on seizure medication.Born with Spina Bifida, paralyzed from waist down.

Answered by Dr. Drkaushal85 (11 hours later)

Brief Answer:
Possibility of worsening aspiration pneumonia is more likely.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
So his cough reflex was affected and he was having neurological problems like stroke, spina bifida etc.
So possibility of aspiration pneumonia is more likely.
Worsening aspiration pneumonia can lead to death.
Please let me know
1. Was he having fever and chest congestion during last week?
2. Was chest x ray done during last week?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Thanks.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Drkaushal85 (21 hours later)

Did my answer transfer to you?

Answered by Dr. Drkaushal85 (3 minutes later)

Brief Answer:
I replied to your first follow up query.

Detailed Answer:
Thanks for your follow up question.
I have already replied to your first follow up question.

Did you get my answer?
And which answer you're referring to here?
I got your first follow up query.

I will be happy to help you further.
Wish you good health.
Thanks.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Drkaushal85 (16 hours later)

X-rays taken,some slight fevers.Scoped lung week earlier, no excess mucus or sign of lung damage.During time in hospital was fed by J tube ,G tube drained stomach.Advised by Physician Assistant to change doctors. New doctor put Gary on steroids for 3 days followed by lascic and water flush.Day 1 heavy breathing,day 2 normal breath,day 3 become conscious,day 4 not conscious -oxygen at 80 82 -breathing treatment given-levels drop-passed away.About week prior to this (peep12-oxg.100 on respirator)breathing level 91-92 same therapist gave treatment at 11PM,levels dropped to 86-85,no success in manual assist -left room.I began messaging below rib cage,88-87 reached ,continued till morning,91-92 breathing without help,98-99 later in day.Last day,same therapist came to room,asked if wanted treatment,said would not make difference,I said no.She returned later with another person and gave treatment. Thank You for help in this matter.

Answered by Dr. Drkaushal85 (19 hours later)

Brief Answer:
Possibility of pulmonary embolism is more.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
First of all sorry for late reply as I was busy with my other professional obligations.
And thanks for detailed description of events.
It seems possibility of pulmonary embolism is more likely.
Pulmonary embolism can cause pulmonary edema which improves with diuretics (Lasix).
Please let me know
1. D dimer was done?
2. Had doctors talked about getting done CT pulmonary angiography?
3. Was he given heparin or enoxaparin?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Thanks.

Above answer was peer-reviewed by : Dr. Vaishalee Punj