title: Recurrent Spontaneous Pneumothorax during the Recovery Phase of ARDS Due to H1N1 Infection.
abstract: The pregnant patients are prone to influenza A (H1N1) virus infection, which may rapidly progress to lower respiratory tract infection and subsequent respiratory failure and acute respiratory distress syndrome (ARDS). Pneumothorax might develop in ARDS under mechanical ventilation. But post-ARDS pneumothorax in spontaneously breathing patient has not been reported in the literature. We report a 31-year old pregnant woman infected with influenza A (H1N1) virus and progressed to ARDS. Mechanical ventilation with high PEEP improved patient's gas exchange parameters within 3 weeks. However spontaneous pneumothorax was developed one week after she weaned off the ventilator. After successful drainage therapy, the patient was discharged. However she re-admitted to the hospital because of a recurrent pneumothorax one week later. She was discharged in good health after being treated with negative continuous pleural aspiration for 10 days. Influenza might cause severe pulmonary infection and death. In addition to diffuse alveolar damage, sub-pleural and intrapulmonary air cysts might occur in influenza-related ARDS and may lead to spontaneous pneumothorax. This complication should always be considered during the recovery period of ARDS and a long-term close follow-up is necessary.
authors.affiliation: Department of Anesthesiology and Reanimation, Faculty of Medicine, Ege University, İzmir, Turkey.
authors.forename: Canan
authors.initials: C
authors.lastname: Bor
authors.affiliation: Department of Anesthesiology and Reanimation, Faculty of Medicine, Ege University, İzmir, Turkey.
authors.forename: Kubilay
authors.initials: K
authors.lastname: Demirağ
authors.affiliation: Department of Anesthesiology and Reanimation, Faculty of Medicine, Ege University, İzmir, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Uyar
authors.affiliation: Department of Anesthesiology and Reanimation, Faculty of Medicine, Ege University, İzmir, Turkey.
authors.forename: Ilkin
authors.initials: I
authors.lastname: Cankayalı
authors.affiliation: Clinic of Anesthesiology and Reanimation, Special izmir City Hospital, İzmir, Turkey.
authors.forename: Ali Reşat
authors.initials: AR
authors.lastname: Moral
keywords: ARDS; H1N1 virus; spontaneous pneumothorax