[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.
Department of Intensive Care Unit, People's Hospital of Guizhou Province, Guiyang 550002, Guizhou, China. liulan670909@yahoo.com.cn
Lan
L
Liu
Zhao-lin
ZL
Sun
Jian-yi
JY
Wang
Xiang-yan
XY
Zhang
Duan-xing
DX
Feng
Yun-chang
YC
Cai
Wei-jia
WJ
Liu
Yuan-dong
YD
Hu
Gui-ping
GP
Zhang
Chun-ling
CL
Ji
Ba-ning
BN
Ye
Yu-hui
YH
Wang
Cen
C
Li
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