Dwivedi Deepak, Bhatia Jagdeep Singh, Hota Rabi Narayan, Sud Saurabh
Department of Anaesthesia and Critical Care, Command Hospital (SC) Armed Forces Medical College, Pune, Maharashtra, India.
Anesth Essays Res. 2019 Oct-Dec;13(4):692-694. doi: 10.4103/aer.AER_124_19. Epub 2019 Dec 16.
Pregnancy with H1N1 infection presenting with early acute respiratory distress syndrome (ARDS) is a challenging situation, where the life of both mother and fetus are jeopardized. Morbidity and mortality in such a clinical situation are not uncommon; it may result in hypoxemic acute respiratory failure in a pregnant patient, leading to mechanical ventilation and poorer outcomes in neonates due to prematurity. An interdisciplinary approach involving obstetricians, respiratory physicians, neonatologist, and anesthesiologist is mandatory for a good outcome. This case report highlights the management strategy of the parturient infected with H1N1 in early ARDS with the Transnasal Humidified Rapid-Insufflation Ventilatory Exchange therapy, which completely obviated the requirement of the invasive ventilation.
妊娠合并甲型H1N1感染并伴有早期急性呼吸窘迫综合征（ARDS）是一种具有挑战性的情况，此时母亲和胎儿的生命都受到威胁。在这种临床情况下，发病率和死亡率并不罕见；它可能导致孕妇出现低氧性急性呼吸衰竭，进而需要机械通气，并且由于早产导致新生儿预后较差。为了取得良好的治疗效果，必须采取由产科医生、呼吸内科医生、新生儿科医生和麻醉医生组成的多学科方法。本病例报告重点介绍了采用经鼻湿化快速充气通气交换疗法对早期ARDS中感染甲型H1N1的产妇的管理策略，该疗法完全避免了有创通气的需求。
