PT  - JOURNAL ARTICLE
AU  - Toshimichi Horiuchi
AU  - Toshiki Yokoyama
AU  - Nobumitsu Kobayashi
AU  - Yosuke Wada
AU  - Hiroshi Yamamoto
AU  - Keishi Kubo
TI  - Biomarker profiles of BALF in ALI/ARDS due to pandemic (H1N1) 2009 influenza
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - p4356
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/p4356.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/p4356.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - Background: The outbreak of the 2009 pandemic influenza A (H1N1) virus was identified as a Pandemic. However, the clinical and epidemiologic characteristics of the novel influenza were not sufficiently elucidated.Methods: Patients who were hospitalized because of the novel influenza infection were enrolled in the study between August 2009 and December 2009 at Shinshu University Hospital. Furthermore, the patients with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) due to influenza A infection were collected. The patients' condition, laboratory data, the respiratory management, and oxygenation were analyzed. Bronchoalveolar lavage (BAL) was performed on admission.Results: Nine patients were hospitalized and treated with anti-viral therapy such as oseltamivir. Five of 9 patients showed ALI/ARDS. Three of the 5 patients were treated with mechanical ventilation. Only one patient died in the intensive care unit because of the refractory hypoxemia due to the deterioration of a co-infection. BAL was performed in 3 patients and all of them showed alveolar hemorrhage. The IL-6, IL-8, KL-6, SP-D, thrombomodulin and HMGB-1 levels in BAL fluid were elevated higher than the serum. The serum concentration of KL-6 and SP-D were elevated on day 3 and 7 in the dead patient only.Conclusion: This study showed lung injury due to 2009 pandemic influenza A (H1N1) virus was formed by the direct ALI/ARDS without a cytokine storm. This suggested that the influenza virus directly injured the lung.