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Journal Information
Vol. 16. Issue 6.
Pages 907-911 (November - December 2010)
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Vol. 16. Issue 6.
Pages 907-911 (November - December 2010)
Review
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H1N1 infection and acute respiratory failure: Can we give non-invasive ventilation a chance?
Infecčão pelo H1N1 e insufi ciência respiratória aguda: será que podemos dar a ventilačão não-invasiva uma oportunidade?
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João Carlos Winck
Corresponding author
jwinck@hsjoao.min-saude.pt

Corresponding author.
, Miguel Gonçalves
Faculdade de Medicina da Universidade do Porto, Porto-Portugal
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Article information
Abstract

In 2009, a novel H1N1 Influenza virus has emerged and on June 11 the World Health Organization declared it as pandemic. It may cause acute respiratory failure ranging from severe Acute Respiratory Distress Syndrome to exacerbations of airflow limitation. Non-invasive ventilation is now considered first-line intervention for different causes of acute respiratory failure and may be considered in the context of H1N1 pandemic. Although infection control issues have been arisen, non-invasive ventilation was effective and safe during the Severe Acute Respiratory Syndrome in Asia. It is reasonable to recommend non-invasive ventilation in H1N1-related exacerbations of chronic respiratory diseases, especially in negative-pressure wards. Treatment of early Acute Respiratory Distress Syndrome associated with H1N1 using non-invasive ventilation could be tried rapidly identifying those who fail without delaying endotracheal intubation. Considering the high demand for critical care beds during the pandemic, non-invasive ventilation may have a role in reducing the estimated load.

Keywords:
Acute respiratory failure
H1N1 Influenza virus
Non-invasive ventilation
Resumo

Em 2009, surgiu um novo vírus da gripe H1N1 e a 11 de Junho a Organização Mundial de Saúde declarou-o como uma pandemia. Poderá causar insuficiência respiratória, do Síndroma de Dificuldade Respiratória Agudo a manifestações de limitação do fluxo de ar. A ventilação não invasiva é agora considerada como a primeira intervenção para diferentes causas de insuficiência respiratória aguda e pode ser considerada no contexto da pandemia de H1N1. Apesar de terem surgido problemas ligados ao controlo da infecção, a ventilação não invasiva foi eficaz e segura durante o Síndroma de Dificuldade Respiratória Agudo na Ásia. É razoável recomendar a ventilação não invasiva nas manifestações de doenças respiratórias crónicas ligadas ao H1N1, especialmente em serviços com pressão negativa. O tratamento do Síndroma de Dificuldade Respiratória Agudo precoce associado ao H1N1 utilizando ventilação não invasiva pode ser experimentado para identificar rapidamente aqueles que falham sem atrasar a intubação endotraqueal. Considerando a elevada procura de camas de cuidados intensivos, a ventilação não invasiva pode ajudar a reduzir a sobrelotação estimada.

Palavras-chave:
Insuficiência respiratória aguda
Vírus da gripe H1N1
Ventilação não invasiva
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