高流量鼻導管應用於一名嚴重特殊性肺炎引發肺實質化的14歲少年──病例報告

High Flow Nasal Cannula Application in a 14-year-old Adolescent with Severe Acute Respiratory Syndrome Coronavirus 2-induced Lung Consolidation: A Case Report

新型冠狀病毒（Severe Acute Respiratory Syndrome Coronavirus 2；SARS-CoV-2）感染可能會造成缺氧性呼吸衰竭和急性呼吸窘迫症候群，嚴重者會導致休克、死亡的後果。我們在此報告一名14歲少年，因發燒、呼吸困難使用抗原快篩檢測確診SARS-CoV-2，入院隔離治療。同時在血液培養及痰液培養中發現有細菌感染，病程變化十分迅速，引發左肺大片實質化，經使用高流量鼻導管（High flow nasal cannula；HFNC）作為呼吸支持，降低呼吸急促和改善氣體交換，並且使用抗病毒藥物及跨科團隊醫療照護下，病童的症狀有明顯改善。病毒循環數閾值（Cycle Threshold；Ct值）達解除隔離標準，順利康復出院。藉此個案報告，了解兒科患者在使用HFNC模式的選擇及流量的設定有別於一般成人的設定。搜尋相關文獻以供未來改善患者呼吸狀況方面的重要性，以及其在相關臨床場景中的應用價值。

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection can cause hypoxic respiratory failure and acute respiratory distress syndrome, and in severe cases, it can lead to shock and death. We report here a 14-year-old adolescent who was diagnosed with SARS-CoV-2 by an antigen rapid test due to fever and respiratory distress, and was admitted for isolation treatment. Bacterial infection was also detected in blood and sputum cultures. The disease progressed rapidly and caused substantial consolidation in the left lung. High flow nasal cannula (HFNC) was used as respiratory support to reduce respiratory distress and improve gas exchange. Antiviral drugs were also administered, and interdisciplinary medical care was provided. The patient’s symptoms significantly improved, and the viral cycle threshold (Ct) value reached the criteria for discharge. The patient was discharged from the hospital after a successful recovery.