A case of severe ARDS caused by novel swine-origin influenza (A/H1N1pdm) virus: a successful treatment with direct hemoperfusion with polymyxin B-immobilized fiber

Journal of Clinical Apheresis
Toshiki YokoyamaKeishi Kubo

Abstract

In 2009, a 35-year-old female with Down syndrome was admitted to our hospital because of severe pneumonia caused by an infection with the novel swine-origin influenza (A/H1N1pdm) virus (S-OIV). A chest X-ray on admission revealed bilateral infiltration shadows. Although mechanical ventilation was administered because of the development of ARDS, the hypoxemia continued to progressed. We observed evidence of alveolar hemorrhage on evaluation of the patient using bronchofiberscopy. The bacterial examination was negative. Despite intensive care, including respiratory management with high-frequency oscillatory ventilation (HFOV), the patient's hypoxemia and hypotension progressed. We concluded that a cytokine storm due to the influenza infection with SIRS caused shock status, resulting in septic shock. We subsequently treated the patient with direct hemoperfusion with polymyxin B-immobilized fiber (PMX-DHP). The hypoxemia improved immediately. She was free from mechanical ventilation and discharged from the hospital by the 17th day of her hospitalization. PMX-DHP seems to improve hypoxemia in patients with severe ARDS who cannot maintain sufficient respiratory control under mechanical ventilation. This case is the first report about...Continue Reading

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Citations

Aug 6, 2011·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Tsukasa NakamuraHikaru Koide
Oct 17, 2014·Internal Medicine·Raine TataraTadashi Nagai
Nov 11, 2015·Kansenshōgaku zasshi. The Journal of the Japanese Association for Infectious Diseases·Mayuri NakanoYasuhiko Nishioka
Dec 14, 2011·Clinical Drug Investigation·So-Hee LeeSang-Heon Cho

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