Winck João Carlos, Gonçalves Miguel
Faculdade de Medicina da Universidade do Porto, Porto-Portugal.
Rev Port Pneumol. 2010 Nov-Dec;16(6):907-11. doi: 10.1016/s0873-2159(15)31253-8.
In 2009, a novel H1N1 Influenza virus has emerged and on June 11 the World Health Organization declared it as pandemic. It may cause acute respiratory failure ranging from severe Acute Respiratory Distress Syndrome to exacerbations of airflow limitation. Non-invasive ventilation is now considered first-line intervention for different causes of acute respiratory failure and may be considered in the context of H1N1 pandemic. Although infection control issues have been arisen, non-invasive ventilation was effective and safe during the Severe Acute Respiratory Syndrome in Asia. It is reasonable to recommend non-invasive ventilation in H1N1-related exacerbations of chronic respiratory diseases, especially in negative-pressure wards. Treatment of early Acute Respiratory Distress Syndrome associated with H1N1 using non-invasive ventilation could be tried rapidly identifying those who fail without delaying endotracheal intubation. Considering the high demand for critical care beds during the pandemic, non-invasive ventilation may have a role in reducing the estimated load.
2009年，一种新型甲型H1N1流感病毒出现，6月11日世界卫生组织宣布其为大流行病毒。它可能导致急性呼吸衰竭，范围从严重急性呼吸窘迫综合征到气流受限加重。无创通气现在被认为是针对不同原因急性呼吸衰竭的一线干预措施，在甲型H1N1流感大流行的情况下也可考虑采用。尽管出现了感染控制问题，但无创通气在亚洲严重急性呼吸综合征期间是有效且安全的。在甲型H1N1流感相关的慢性呼吸道疾病加重期，尤其是在负压病房，推荐使用无创通气是合理的。对于与甲型H1N1流感相关的早期急性呼吸窘迫综合征，可尝试使用无创通气迅速识别治疗无效的患者，而不延迟气管插管。考虑到大流行期间对重症监护病床的高需求，无创通气可能在减轻预计负担方面发挥作用。
