Methylprednisolone infusion for life-threatening H1N1-virus infection.
Methylprednisolone infusion for life-threatening H1N1-virus infection.
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DOI：
10.1177/1753465810376951
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发表时间：
2010-08-01
影响因子：
4.3
通讯作者：
Gabrielli, Marco
中科院分区：
文献类型：
--
作者：
Confalonieri, Marco;Cifaldi, Rossella;Gabrielli, Marco
BACKGROUND: During winter 2009 we treated with prolonged corticosteroid infusion eight consecutive patients affected by H1N1-virus infection and severe pneumonia. The most severe patient was a previously healthy 30-year-old man admitted to hospital because of bilateral pneumonia and severe acute respiratory failure.METHOD: H1N1-virus infection was detected by broncho-alveolar lavage performed on day 1. After some days following admission the patient was still in a life-threatening state, not responding to oseltamivir, protective mechanical ventilation and veno-arterial extracorporeal membrane oxygenation (ECMO).RESULTS: The addition of methylprednisolone infusion at a stress dose (1 mg/kg/24 h) as rescue therapy significantly and rapidly improved the clinical condition. Weaning from ECMO and invasive mechanical ventilation was possible within a relatively few days.CONCLUSION: According to the literature reports more than 34% of H1N1-virus severe infections were treated with corticosteroids. This report and our experience may suggest a possible life-saving use of corticosteroids at a stress dose in severely ill patients with an H1N1-virus infection that is not responding to the most advanced treatments.
