Cases with life-threatening respiratory failure due to influenza A (H1N1) virus infection in intensive care unit

Abstract

We present four cases in critical condition diagnosed as influenza A (H1N1) infection with significant risk factors and severe hypoxemia. Their chest X-rays showed bilateral extensive infiltrative lesions. The ratio of partial arterial oxygen pressure to inspired fraction of oxygen (Pa- O2/FiO2) of the patients was below 200. Three of the patients were given oseltamivir before laboratory confirmation of diagnosis. Influenza A virus infections were confirmed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) test from nasopharyngeal swabs. Lung protective invasive ventilation and positive end-expiratory pressure (PEEP) titration were performed in early period. Three patients were ventilated 5-7 days and discharged to ward uneventfully. In conclusion, we want to emphasize that antiviral treatment, intensive care and invasive mechanical ventilation in early period can decrease mortality and intensive care unit stay in patients with severe hypoxemia. © 2011 by Türkiye Klinikleri.