[上期回顾]中年女性,病程9 d,主要表现为发热伴咳嗽及呼吸困难。入院时高热,呼吸频数,肺部闻及大量湿性啰音,影像学检查示双肺散在斑片状影。诊断:发热查因、肺部感染、急性呼吸窘迫综合征。积极予呼吸末正压通气、抗感染等治疗,每日气管内吸出大量血性液体,患者氧合进一步恶化,入院16 d抢救无效死亡。[病例讨论]本例死亡诊断为:脓毒症、急性呼吸窘迫综合征、毛细血管渗漏综合征、多脏器功能障碍综合征。死亡讨论分析本例顽固性低氧血症为毛细血管渗漏综合征所致。 [Previous review] Middle-aged women, duration 9 d, mainly manifested as fever with cough and dyspnea. High fever on admission, respiratory rate, lung smell and a large number of wet rales, radiographs showed lung scattered patchy shadow. Diagnosis: fever Chane, lung infection, acute respiratory distress syndrome. Positive positive end-expiratory pressure ventilation, anti-infection and other treatment, a large number of bloody fluid inhaled daily tracheal, oxygenation patients further deterioration, 16 days after admission rescue died. Case Discussion Deaths in this case were diagnosed as sepsis, acute respiratory distress syndrome, capillary leak syndrome, multiple organ dysfunction syndrome. Death Discussion and Analysis of refractory hypoxemia in this case caused by capillary leak syndrome.