[A discussion about the tactics of mechanical ventilation for acute respiratory distress occurring in the first case of influenza A (H5N1) in Guizhou Province].
OBJECTIVE
To discuss the tactics of mechanical ventilation in a human severe case of influenza A (H5N1) complicated with acute respiratory distress syndrome (ARDS).


METHODS
The data of the patient infected by the influenza A (H5N1) admitted to People's Hospital of Guizhou Province on January 15, 2009, were analyzed and summarized.


RESULTS
The patient, a 29-year-old man, had been healthy in the past, but had exposed to the environment of bird flu before illness. The initial symptom was unremitting high fever, and then the clinical situation deteriorated progressively with occurrence of dyspnea. Pulmonary infiltrates were evident in the left lower lobe on January 19, and rapidly progressed to involve bilateral lungs presenting ARDS-like changes. Mechanical ventilation became the most important treatment among others. The ventilation mode was synchronized intermittent mandatory ventilation (SIMV)+ pressure support (PS) + positive end expiratory pressure (PEEP), following lung protective ventilatory strategies, with low tidal volume. The patient's condition improved day by day without developing multiple organ dysfunction. The patient fully recovered and was discharged on February 6.


CONCLUSIONS
Early detection, early diagnosis, and finely effective intervention are to improve oxygenation by mechanical ventilation with low tidal volume and adequate PEEP are critical to reducing the mortality.
Liu
Lan
L
Department of Intensive Care Unit, People's Hospital of Guizhou Province, Guiyang 550002, Guizhou, China. liulan670909@yahoo.com.cn
Sun
Zhao-lin
ZL
Wang
Jian-yi
JY
Zhang
Xiang-yan
XY
Feng
Duan-xing
DX
Cai
Yun-chang
YC
Liu
Wei-jia
WJ
Hu
Yuan-dong
YD
Zhang
Gui-ping
GP
Ji
Chun-ling
CL
Ye
Ba-ning
BN
Wang
Yu-hui
YH
Li
Cen
C
D000328:Adult; D002681:China; D006801:Humans; D053124:Influenza A Virus, H5N1 Subtype; D007251:Influenza, Human / Q000150:complications*; D008297:Male; D012121:Respiration, Artificial / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000628:therapy* / Q000821:virology