BACKGROUND: Data on the mechanical ventilation (MV) characteristics and radiologic features for the cases with H7N9-induced ARDS were still 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.
BACKGROUND: Data on the mechanical ventilation (MV) characteristics and radiologic features for the cases with H7N9-induced ARDS were still 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-infectedpatients 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.
Authors: Belaïd Bouhemad; Hélène Brisson; Morgan Le-Guen; Charlotte Arbelot; Qin Lu; Jean-Jacques Rouby Journal: Am J Respir Crit Care Med Date: 2010-09-17 Impact factor: 21.405
Authors: Pier Paolo Terragni; Lorenzo Del Sorbo; Luciana Mascia; Rosario Urbino; Erica L Martin; Alberto Birocco; Chiara Faggiano; Michael Quintel; Luciano Gattinoni; V Marco Ranieri Journal: Anesthesiology Date: 2009-10 Impact factor: 7.892
Authors: V Marco Ranieri; Gordon D Rubenfeld; B Taylor Thompson; Niall D Ferguson; Ellen Caldwell; Eddy Fan; Luigi Camporota; Arthur S Slutsky Journal: JAMA Date: 2012-06-20 Impact factor: 56.272
Authors: Kelvin K W To; Ivan F N Hung; Iris W S Li; Kar-Lung Lee; Chi-Kwan Koo; Wing-Wa Yan; Raymond Liu; Ka-Ying Ho; Kwok-Hong Chu; Chi-Leung Watt; Wei-Kwang Luk; Kang-Yiu Lai; Fu-Loi Chow; Thomas Mok; Tom Buckley; Jasper F W Chan; Samson S Y Wong; Bojian Zheng; Honglin Chen; Candy C Y Lau; Herman Tse; Vincent C C Cheng; Kwok-Hung Chan; Kwok-Yung Yuen Journal: Clin Infect Dis Date: 2010-03-15 Impact factor: 9.079