[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]
World J Emerg Med. 2018;9(2):118-124. doi: 10.5847/wjem.j.1920-8642.2018.02.006.
Ventilator management for acute respiratory distress syndrome associated with avian influenza A (H7N9) virus infection: A case series.
Xie H1, Zhou ZG1, Jin W1, Yuan CB1, Du J1, Lu J1, Wang RL1.
Author information: 1 Department of Critical Care Medicine, Shanghai General Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.
Data on the mechanical ventilation (MV) characteristics and radiologic features for the cases with H7N9-induced ARDS were still lacking.
We describe the MV characteristics and radiologic features of adult patients with ARDS due to microbiologically confirmed H7N9 admitted to our ICU over a 3-month period.
Eight patients (mean age 57.38±16.75; 5 male) were diagnosed with H7N9 in the first quarter of 2014. All developed respiratory failure complicated by acute respiratory distress syndrome (ARDS), which required MV in ICU. The baseline APACHE II and SOFA score was 11.77±6.32 and 7.71±3.12. The overall CT scores of the patients was 247.68±34.28 and the range of CT scores was 196.3-294.7. The average MV days was 14.63±6.14, and 4 patients required additional rescue therapies for refractory hypoxemia. Despite these measures, 3 patients died.
In H7N9-infected patients with ARDS, low tidal volume strategy was the conventional mode. RM as one of rescue therapies to refractory hypoxemia in these patients with serious architectural distortion and high CT scores, which could cause further lung damage, may induce bad outcomes and requires serious consideration. Prone ventilation may improve mortality, and should be performed at the early stage of the disease, not as a rescue therapy.
KEYWORDS: Acute respiratory distress syndrome; H7N9; Influenza A virus; Mechanical ventilation; Prone positioning; Recruitment maneuvers; Viral pneumonia
PMID: 29576824 PMCID: PMC5847497 DOI: 10.5847/wjem.j.1920-8642.2018.02.006
Keywords: Avian Influenza; Human; China; H7N9; ARDS.