Author: Quispe-Laime, Adolfo Maximo; Bracco, Jonas Daniel; Barberio, Patricia Alejandra; Campagne, Claudio German; Rolfo, Verónica Edith; Umberger, Reba; Meduri, Gianfranco Umberto
Title: H1N1 influenza A virus-associated acute lung injury: response to combination oseltamivir and prolonged corticosteroid treatment Cord-id: 5a8yb708 Document date: 2009_11_19
ID: 5a8yb708
Snippet: PURPOSE: During the 2009 H1N1 influenza A virus pandemic, a minority of patients developed rapidly progressive pneumonia leading to acute lung injury (ALI)—acute respiratory distress syndrome (ARDS). A recent meta-analysis provides support for prolonged corticosteroid treatment in ALI-ARDS. We prospectively evaluated the response to oseltamivir and prolonged corticosteroid treatment in patients with ALI-ARDS and suspected H1N1 influenza. METHODS: From June 24 through 12 July 2009, 13 patients
Document: PURPOSE: During the 2009 H1N1 influenza A virus pandemic, a minority of patients developed rapidly progressive pneumonia leading to acute lung injury (ALI)—acute respiratory distress syndrome (ARDS). A recent meta-analysis provides support for prolonged corticosteroid treatment in ALI-ARDS. We prospectively evaluated the response to oseltamivir and prolonged corticosteroid treatment in patients with ALI-ARDS and suspected H1N1 influenza. METHODS: From June 24 through 12 July 2009, 13 patients with suspected H1N1 pneumonia and ALI-ARDS were admitted to the intensive care unit (ICU) of a tertiary care hospital. H1N1 influenza was confirmed with real-time reverse transcriptase-polymerase chain reaction assay in eight patients. Oseltamivir and corticosteroid treatment were initiated concomitantly at ICU admission; those with severe ARDS received methylprednisolone (1 mg/kg/day), and others received hydrocortisone (300 mg/day) for a duration of 21 ± 6 days. RESULTS: Patients with and without confirmed H1N1 influenza had similar disease severity at presentation and a comparable response to treatment. By day 7 of treatment, patients experienced a significant improvement in lung injury and multiple organ dysfunction scores (P < 0.001). Twelve patients (92%) improved lung function, were extubated, and discharged alive from the ICU. Hospital length of stay and mortality were 18.7 ± 9.6 days and 15%, respectively. Survivors were discharged home without oxygen supplementation. CONCLUSIONS: In ARDS patients, with and without confirmed H1N1 influenza, prolonged low-to-moderate dose corticosteroid treatment was well tolerated and associated with significant improvement in lung injury and multiple organ dysfunction scores and a low hospital mortality. These findings provide the rationale for developing a randomized trial.
Search related documents:
Co phrase search for related documents- abnormal chest radiograph and acute respiratory syndrome: 1, 2, 3, 4, 5, 6
- abnormal chest radiograph and lung function: 1
- absolute reduction and acute ards respiratory distress syndrome: 1, 2
- absolute reduction and acute hypoxemic respiratory failure: 1, 2
- absolute reduction and acute organ dysfunction: 1
- absolute reduction and acute respiratory syndrome: 1, 2, 3, 4, 5, 6, 7
- absolute reduction and lung injury: 1
- absolute reduction and lung involvement: 1
- abstract purpose and acute ards respiratory distress syndrome: 1, 2
- abstract purpose and acute respiratory syndrome: 1, 2, 3, 4, 5
- abstract purpose and additional patient: 1
- abstract purpose and lung disease: 1
- abstract purpose and lung involvement: 1, 2
- acute ards respiratory distress syndrome and additional patient: 1, 2
- acute ards respiratory distress syndrome and long duration: 1, 2, 3, 4
- acute ards respiratory distress syndrome and low hospital mortality: 1
- acute ards respiratory distress syndrome and lung compliance: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49
- acute ards respiratory distress syndrome and lung disease: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73
- acute ards respiratory distress syndrome and lung function: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66
Co phrase search for related documents, hyperlinks ordered by date