Noninvasive mechanical ventilation in severe pneumonia due to H1N1 virus

Objective: 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. Design: Retrospective and observational study. Setting: ICU of Castellon University General Hospital (Castellon, Spain). Population: Patients admitted to ICU with pneumonia due to influenza A virus H1N1 and acute hypoxemic respiratory failure. Interventions: Boussignac CPAP, Helmet system and BiPAP Vision (R) were used. Results: 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. Conclusions: Based on our results, increased use of noninvasive mechanical ventilation in future epidemics coujld be proposed. (C) 2011 Elsevier Espana, S.L. and SEMICYUC. All rights reserved.