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Ventilator management for acute respiratory distress syndrome associated with avian influenza A (H7N9) virus infection: A case series

摘要BACKGROUND: Data on the mechanical ventilation (MV) characteristics and radiologic features for the cases with H7N9-induced ARDS were stil lacking. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

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DOI 10.5847/wjem.j.1920–8642.2018.02.006
发布时间 2018-07-04(万方平台首次上网日期,不代表论文的发表时间)
基金项目
the National Natural Science Foundation of China((grant number 81501654)) Natural Science Foundation of Shanghai((grant number 14ZR1433700))
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世界急诊医学杂志(英文)

世界急诊医学杂志(英文)

2018年9卷2期

118-124页

SCIMEDLINEISTICCSCDCA

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