Belenguer-Muncharaz A, Reig-Valero R, Altaba-Tena S, Casero-Roig P, Ferrándiz-Sellés A
Servicio de Medicina Intensiva, Hospital General Castellón, Castellón, España.
Med Intensiva. 2011 Nov;35(8):470-7. doi: 10.1016/j.medin.2011.04.001. Epub 2011 May 19.
The use of noninvasive mechanical ventilation was evaluated in our series of patients admitted to our ICU with pneumonia due to influenza A virus H1N1, assessing the need for intubation, arterial blood gases and clinical improvement, the development of complications and ICU and hospital stay.
Retrospective and observational study.
ICU of Castellón University General Hospital (Castellón, Spain).
Patients admitted to ICU with pneumonia due to influenza A virus H1N1 and acute hypoxemic respiratory failure.
Boussignac CPAP, Helmet system and BiPAP Vision(®) were used.
Five of 10 patients with pneumonia and hypoxemia were analyzed, showing 100% effectiveness of noninvasive mechanical ventilation in terms of clinical and arterial blood gas improvement, and avoiding intubation in all cases. There were no patient deaths in ICU or in hospital. The duration (median) of ventilation was 6 (4-11) days, with an ICU stay of 9 (7-11) days. The number of complications was low (except for urinary tract infection due to Pseudomonas aeruginosa), and only the noise produced by CPAP was underscored. There were no infections among the staff.
Based on our results, increased use of noninvasive mechanical ventilation in future epidemics coujld be proposed.
对我院重症监护病房（ICU）收治的甲型H1N1流感病毒所致肺炎患者使用无创机械通气进行评估，评估插管需求、动脉血气及临床改善情况、并发症的发生以及ICU住院时间和住院总时长。
回顾性观察研究。
西班牙卡斯特利翁大学综合医院ICU。
因甲型H1N1流感病毒所致肺炎及急性低氧性呼吸衰竭而入住ICU的患者。
使用布西尼亚克持续气道正压通气（CPAP）、头盔系统和双水平气道正压通气（BiPAP Vision®）。
对10例肺炎合并低氧血症患者中的5例进行了分析，结果显示无创机械通气在临床和动脉血气改善方面的有效率达100%，且所有病例均避免了插管。ICU及住院期间均无患者死亡。通气时间（中位数）为6（4 - 11）天，ICU住院时间为9（7 - 11）天。并发症数量较少（除铜绿假单胞菌所致尿路感染外），仅强调了CPAP产生的噪音。医护人员中未发生感染。
基于我们的研究结果，建议在未来疫情中增加无创机械通气的使用。
