ABSTRACT
A 48-year-old woman admitted to the She developed ARDS secondary to biliary sepsis following ventilated via a tracheostomy using a lung protective strategy. She has a history of bilateral pneumothoraces and has multiple chest drains in situ, none of which are presently bubbling. In the last 24 hours gas exchange has deteriorated requiring an increased FiO2. In addition she has required theintroduction of inotropic support. She has a fever and is now productive of sputum, and has developed a new pulmonary infiltrate on CXR. The patient’s WCC is elevated.
