Pandemic (H1N1) 2009-associated ARDS rescued by neuraminidase inhibitors with emergency use of extracorporeal membrane oxygenation.
A 36-year-old man with underlying systemic lupus erythematosus complicated by autoimmune hemolytic anemia underwent immunosuppressive treatment. After showing a low-grade fever for two days, his fever spiked. He was confirmed to have pandemic (H1N1) 2009 by real-time reverse transcription polymerase chain reaction (PCR). His condition deteriorated to acute respiratory distress syndrome (ARDS), and mechanical ventilation became necessary. The lowest PaO(2)/FIO(2) ratio was 77, and he was placed on extracorporeal membrane oxygenation (ECMO). Based on our observation, the emergency use of ECMO in addition to peramivir might be useful. A noteworthy point is that once ARDS deteriorates due to pandemic (H1N1) 2009, intensive supportive care should be started.
Nakanishi
Hideyuki
H
Department of Internal Medicine, Matsuyama Red-Cross Hospital, Matsuyama, Japan.
Muta
Tsuyoshi
T
Fujisaki
Tomoaki
T
Yoshitomi
Ryota
R
Kubo
Toshihiko
T
Yokota
Eisuke
E
D000146:Acids, Carbocyclic; D000328:Adult; D000744:Anemia, Hemolytic, Autoimmune / Q000150:complications; D000998:Antiviral Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003517:Cyclopentanes / Q000627:therapeutic use*; D004196:Disease Outbreaks; D004630:Emergencies; D015199:Extracorporeal Membrane Oxygenation; D006146:Guanidines / Q000627:therapeutic use*; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D053118:Influenza A Virus, H1N1 Subtype / Q000201:enzymology / Q000302:isolation & purification; D007251:Influenza, Human / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy; D008297:Male; D009439:Neuraminidase / Q000037:antagonists & inhibitors*; D010102:Oxygen Inhalation Therapy; D011239:Prednisolone / Q000627:therapeutic use; D011859:Radiography; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D014764:Viral Proteins / Q000037:antagonists & inhibitors*
D000146:Acids, Carbocyclic; D000998:Antiviral Agents; D003517:Cyclopentanes; D006146:Guanidines; D007166:Immunosuppressive Agents; D014764:Viral Proteins; D011239:Prednisolone; C487630:NA protein, influenza A virus; D009439:Neuraminidase; C414210:peramivir