tailieunhanh - Báo cáo y học: "Non-invasive ventilation in acute respiratory failure related to 2009 pandemic Influenza A/H1N1 virus infection"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Non-invasive ventilation in acute respiratory failure related to 2009 pandemic Influenza A/H1N1 virus infection. | Winck and Marinho Critical Care 2010 14 408 http content 14 2 408 CRITICAL CARE LETTER L_ Non-invasive ventilation in acute respiratory failure related to 2009 pandemic Influenza A H1N1 virus infection João Carlos Winck -2 and Anabela Marinho1 See related research by Rello http content 13 5 R148 Non-invasive ventilation NIV is considered first-line intervention for different causes of acute respiratory failure 1 . However Rello and colleagues 2 show high rates of NIV failure in pandemic Influenza A H1N1 virus infection PH1N1 . We describe a patient with PH1N1 in whom NIV was effective. A 53-year-old male was admitted in November 2009 with cough dyspnea and hemoptysis. His temperature was C he was tachypneic with diffuse rhonchi and bilateral crackles and oxygen saturation was 96 4 L min oxygen . Arterial partial pressure of oxygen PaO2 and arterial partial pressure of carbon dioxide PaCO2 were 76 and 23 mm Hg respectively. Creatine kinase 2 278 U L and brain natriuretic peptide 3 544 pg mL were increased. Acute myocardial infarction was excluded. Chest x-ray showed bilateral interstitial infiltrates and cardiomegaly. Echocardiogram showed severe left ventricular systolic dysfunction. PH1N1 pneumonia was suspected and oseltamivir was administered in association with antibiotics and diuretics. On day 2 a nasopharyngeal swab was positive for PH1N1. The patient was subsequently transferred to a negativepressure ward. He was still tachypneic with basal crackles and a PaO2 fraction of inspired oxygen FiO2 ratio of 246. NIV BiPAP Vision Philips Respironics Murrysville PA USA through an oro-nasal mask in bilevel positive airway pressure mode inspiratory positive airway pressure IPAP 16 cm H2O expiratory positive airway pressure EPAP 8 cm H2O was started. Due to patient preference the mode was changed to continuous positive airway pressure CPAP at 10 cm H2O and an FiO2 of 25 . After 1 hour PaO2 FiO2 increased to 364 and CPAP was .