PT  - JOURNAL ARTICLE
AU  - Eva Tonveronachi
AU  - Ilaria Valentini
AU  - Andrea Fabiani
AU  - Rosanna Vaschetto
AU  - Antonina Pigna
AU  - Riccardo Maviglia
AU  - Gabriela Sangiorgi
AU  - Massimo Gorini
AU  - Marco Adversi
AU  - Gianfranco Di Nino
AU  - Stefano Faenza
AU  - Massimo Antonelli
AU  - Paolo Navalesi
AU  - Stefano Nava
TI  - Noninvasive mechanical ventilation in patients with acute respiratory failure due to H1N1 infection
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - 2968
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/2968.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/2968.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - We evaluated the clinical outcomes of consecutive patients positive for H1N1 and admitted to 6 Intensive Care Units in Italy for severe Acute Respiratory Failure and requiring non-invasive mechanical ventilation (NIV). 29/54 (54%) patients admitted to the ICUs needed immediate intubation for gasping, coma or respiratory arrest. The remaining 25 patients (mean age 49.8±12) underwent an NIV trial as a first line treatment using the helmet (n.19 patients) or a total face mask (n.6). Arterial Blood Gases (ABGs) at enrolment were: pH=7,41±0.02, PaO2/FiO2=117±64 and PaCO2=40,5±9. At the first ABGs control (between 30' and 90') PaO2/FiO2 significantly (p<0.001) improved to 187±43 with a concomitant decrease in PaCO2 to 36.4±9. Mean duration of NIV was 49.8±33 hrs. 10/25 (40%) of the patients required intubation after 20.3 hrs. Overall mortality rate was 7/25 (28%), with all the deaths occurring in the NIV failure group. NIV failure had a lower PaO2/FiO2 at admission (78.6±21 vs 152.4±32 p<0.01, for NIV failure and success, respectively) and 5/7 patients had a known risk factor (i.e.hematological malignancies (n.2), previous solid organ transplant (n.1),multiple sclerosis (n.1) and CHF (n.1) None of the operators were apparently contaminated by the virus. NIV may be safely used to treat patients with severe ARF due to H1N1 infections. The success rate was similar for that reported in the literature for ALI/ARDS patients.