H1N1 influenza-associated pneumonia with severe obesity: successful management with awake veno-venous extracorporeal membrane oxygenation and early respiratory physical therapy.

CASE

We report a case of H1N1 influenza-associated respiratory failure with severe obesity.

OUTCOME

A 54-year-old man was admitted to our intensive care unit (ICU) because of H1N1 influenza-associated severe respiratory failure. He was severely obese, having a body mass index of 37.2. His respiratory condition remained severe under mechanical ventilation. We started veno-venous extracorporeal membrane oxygenation immediately. Awake management was started on ICU Day 6, and the patient's respiratory physical therapy began the following day. His respiratory condition showed excellent improvement immediately following the initiation of respiratory physical therapy. The patient was successfully decannulated on ICU Day 9, and he was discharged from the ICU on Day 11. He was discharged from the hospital with no severe disability on disease Day 60.

CONCLUSION

Awake extracorporeal membrane oxygenation management with early respiratory physical therapy can be useful in the treatment of morbidly obese patients who present with severe respiratory failure.