Cases with Life-Threatening Respiratory Failure due to Influenza A (H1N1) Virus Infection in Intensive Care Unit

ABS TRACT We pre sent fo ur ca ses in cri ti cal con di ti on di ag no sed as inf lu en za A (H1N1) in fec ti on with sig ni fi cant risk fac tors and se ve re hypo xe mi a. The ir chest X-rays sho wed bi la te ral ex ten si ve in fil tra ti ve le si ons. The ra ti o of par ti al ar te ri al oxy gen pres su re to ins pi red frac ti on of oxy gen (Pa O2/Fi O2) of the pa ti ents was be low 200. Thre e of the pa ti ents we re gi ven osel ta mi vir be fo re la bo ra tory con fir ma ti on of di ag no sis. Inf lu en za A vi rus in fec ti ons we re con fir med by re al-ti me re ver se trans crip ta se-poly me ra se cha in re ac ti on (RT-PCR) test from na sop hary nge al swabs. Lung pro tec ti ve in va si ve ven ti la ti on and po si ti ve end-ex pi ra tory pres su re (PE EP) tit ra ti on we re per for med in early pe ri od. Thre e pa ti ents we re ven ti la ted 5-7 days and disc har ged to ward une vent fully. In conc lu si on, we want to emp ha si ze that an ti vi ral tre at ment, in ten si ve ca re and in va si ve mec ha ni cal ven ti la ti on in early pe ri od can dec re a se mor ta lity and intensive care unit stay in pa ti ents with se ve re hypo xe mi a.