Superimposed high-frequency jet ventilation combined with continuous positive airway pressureassisted spontaneous breathing improves oxygenation in patients with H1N1-associated ARDS 英文参考文献.docVIP

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Superimposed high-frequency jet ventilation combined with continuous positive airway pressureassisted spontaneous breathing improves oxygenation in patients with H1N1-associated ARDS 英文参考文献.doc

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Superimposed high-frequency jet ventilation combined with continuous positive airway pressureassisted spontaneous breathing improves oxygenation in patients with H1N1-associated ARDS 英文参考文献

Bingoldetal.AnnalsofIntensiveCare2012,2:7 /content/2/1/7 RESEARCH OpenAccess Superimposedhigh-frequencyjetventilation combinedwithcontinuouspositiveairway pressure/assistedspontaneousbreathing improvesoxygenationinpatientswithH1N1- associatedARDS TobiasMBingold1*,BertramScheller1,TimoWolf2,JensMeier1,AlexanderKoch1,KaiZacharowski1, PeterRosenberger1andThomasIber1 Abstract Background:Numerouscasesofswine-origin2009H1N1influenzaAvirus(H1N1)-associatedacuterespiratory distresssyndrome(ARDS)bridgedbyextracorporealmembraneoxygenation(ECMO)therapyhavebeenreported; however,complicationratesarehigh.WepresentourexperiencewithH1N1-associatedARDSandsuccessful bridgingoflungfunctionusingsuperimposedhigh-frequencyjetventilation(SHFJV)incombinationwith continuouspositiveairwaypressure/assistedspontaneousbreathing(CPAP/ASB). Methods:WeadmittedfivepatientswithH1N1infectionandARDStoourintensivecareunit.Althoughall patientsrequiredpureoxygenandcontrolledventilation,oxygenationwasinsufficient.WeappliedSHFJV/CPAP/ ASBtoimproveoxygenation. Results:InitialPaO2/FiO2ratiopriorSHFJVwas58-79mmHg.Inallpatients,successfuloxygenationwasachieved bySHFJV(PaO2/FiO2ratio105-306mmHgwithin24h).Spontaneousbreathingwassetduringfirsthoursafter admission.SHFJVcouldbestoppedafter39,40,72,100,or240h.Concomitantpulmonaryherpessimplexvirus (HSV)infectionwasobservedinallpatients.Twopatientsweresuccessfullydischarged.Theotherthreepatients relapsedanddiedwithin7weeksmainlyduetocombinedHSVinfectionandintwocasesreoccurringH1N1 infection. Conclusions:SHFJVrepresentsanalternativetobridgelungfunctionsuccessfullyandimproveoxygenationinthe criticallyill. Background NewZealanddescribesanincidenceofmechanicalven- The swine-origin 2009 H1N1 influenza A virus has tilation in 64.6% of H1N1 patients and 11.6% ECMO become the predominant influenza virus worldwide (with a mortality of approximately 21%) treated within since its identification. H1N1 influenza might cause theintensivecareunit(ICU)[2]. acuterespiratorydist