Mrs. Sheela Gracy 34 years old, a known case of Hypertension, Chronic kidney disease on HD, Hypothyroidism and post ASD closure. she has complaints of breathing difficulty, generalized body pain, and fever for 2 days. In view of tachypnoea, noninvasive ventilation was initiated. Chest x-ray showed pulmonary edema features. On examination, she developed hypertension and she is requiring IV
antihypertensives. Baseline investigations showed elevated serum creatinine, requiring dialysis. At present patient is in ICU intense monitoring. She is still receiving NIV support. The patient needs 3 more days of ICU intense monitoring overall cost comes around Rs 35,000 to 40,000 per day and followed by ward management.