Clinical observation on mechanical ventilation in treatment of pediatric severe pneumonia caused by H1N1 influenza

Objective:To explore the function of mechanical ventilation in treatment of pediatric severe pneumonia caused by H1N1 influenza.Methods:The clinical data of 11 children with severe pneumonia caused by H1N1 influenza who underwent mechanical ventilation in the hospital were analyzed retrospectively,then they were divided into group A(7 children,early mechanical ventilation group) and group B(4 children,routine mechanical ventilation group) according to the opportunity of mechanical ventilation.The indications of mechanical ventilation,parameters of ventilator,the time of mechanical ventilation,and curative effect were analyzed.Results:The children in group A were treated with positive pressure ventilation when anhelation,fuzzy shadow of both lungs displayed by chest film,hyperventilation displayed by blood gas analysis occurred,the parameters of ventilator: peak inspiratory pressure(PIP) 22 cm H2O,positive end expiratory pressure(PEEP) 7 cm H2O,FiO2 40%-50%,then hyoxemia was improved,the total application time of mechanical ventilation was 4-5 days,all the children in group A were cured.The children in group B were treated with mechanical ventilation when obvious hypoxemia,large number of wet rales, white lung in both lungs displayed by chest film,type Ⅰeven type Ⅱ respiratory failure displayed by blood gas analysis occurred,the parameters of ventilator: PIP 25 cm H2O,PEEP 10 cm H2O,FiO2 80%-100%,hypoxemia couldn't be improved,after 24-48 hours,transcutaneous oxygen saturation increased to more than 90%,the total application time of mechanical ventilation was 7-10 days,one child died,and the other three children were removed from ventilator safely.Conclusion:Early mechanical ventilation is an effective method to treat pediatric severe pneumonia caused by H1N1 influenza combined with acute respiratory distress syndrome(ARDS);the key point of improving the success rate of mechanical ventilation and preventing pulmonary damage is achieving optimal oxygenation index with the minimal PEEP.