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SMJ // Article

Expired CME Article

Clinical Pathological Characteristics and Management of Acute Respiratory Distress Syndrome Resulting from Influenza A (H1N1) Virus

Authors: Samer Homsi, MD, Natasa Milojkovic, MD, Yamen Homsi, MD

Abstract

Young adults, especially pregnant woman and patients with pre-existing medical conditions, appear to be at risk for the development of severe acute respiratory distress syndrome (ARDS) from influenza A (H1N1) infection, leading to critical hypoxemia. This may require high ventilator settings, the use of nonconventional modes, and extracorporeal membrane oxygenation in some cases. This severe ARDS may be related to prolonged and virulent viral infection, inducing ongoing aberrant immune responses and leading to extensive lung damage. Duration of antiviral therapy, the timing of steroid introduction, and moving away from standard ventilation techniques in ARDS may be key points in disease management.


Key Points


* Acute respiratory distress syndrome (ARDS) from influenza A (H1N1) infection may cause critical hypoxemia, requiring high ventilator settings, the use of nonconventional modes, and in some cases, extracorporeal membrane oxygenation.


* Severe ARDS may be related to prolonged and virulent viral infection, inducing ongoing aberrant immune responses and leading to extensive lung damage.


* Clinicians should watch for signs of possible clinical deterioration, such as shortness of breath—especially in the high-risk group—and should seek early hospital referral.


* Duration of antiviral therapy, timing of introducing steroids, and moving away from standard ventilation techniques in ARDS may be key points in the management of this disease.

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