Methylprednisolone infusion for life-threatening H1N1-virus infection

Therapeutic Advances in Respiratory Disease
Marco ConfalonieriMarco Gabrielli

Abstract

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. 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). 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. 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.

References

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Citations

Mar 4, 2011·Critical Care : the Official Journal of the Critical Care Forum·Gernot BeutelMarius M Hoeper
Apr 5, 2011·Critical Care : the Official Journal of the Critical Care Forum·Hong-Ryang KilJin-Han Kang
Dec 24, 2013·Mediators of Inflammation·Felinda ArianiJieming Qu
Nov 19, 2011·Acta Anaesthesiologica Scandinavica·R LinkoUNKNOWN FINNH1N1-STUDY GROUP
Apr 19, 2015·Critical Care : the Official Journal of the Critical Care Forum·Yi ZhangQuanyi Wang
Aug 9, 2011·Vaccine·Pieter L A Fraaij, Terho Heikkinen
Feb 28, 2014·The Korean Journal of Internal Medicine·Won Suk ChoiUNKNOWN Transgovernmental Enterprise for Pandemic Influenza in Korea
Jun 2, 2020·The Keio Journal of Medicine·Seitaro Fujishima
Oct 24, 2020·Journal of Biomolecular Structure & Dynamics·Rajesh GhoshSnehasis Chowdhuri

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