Extreme Efficiency of Airway Pressure Release Ventilation (APRV) in a Patient Suffering from Acute Lung Injury with Pandemic Influenza A (H1N1) 2009 and High Cytokines

Abstract

The authors report a Japanese boy with severe pandemic influenza A(H1N1) 2009-associated pneumonia and deteriorating oxygenation. He dramatically recovered after the use of Airway Pressure Release Ventilation (APRV) mode. There was no improvement by using any conventional ventilation, however, APRV immediately led to an improvement of his clinical symptoms and laboratory findings.

Ventilator Strategies and Rescue Therapies for Management of Acute Respiratory Failure in the Emergency Department

“…Airway pressure release ventilation has been beneficial in patients with acute respiratory distress syndrome from H1N1 and has been shown to prevent the development of acute respiratory distress syndrome in high-risk trauma patients. 7,[83][84][85][86][87][88] Continuous neuromuscular blockade has been proposed as an adjunct therapy in acute respiratory distress syndrome to improve patient-ventilator synchrony and chest wall compliance, and to reduce ventilator-induced lung injury. A large-scale randomized controlled trial of early continuous neuromuscular blockade for 48 hours demonstrated a mortality and duration of mechanical ventilation benefit compared with that of a control group.…”