Noninvasive Positive-Pressure Ventilation in an Elderly Woman with Acute Respiratory Failure Caused by Influenza A Virus Pneumonia.

DOI PubMed 12 References
  • Kikawada Masayuki
    Department of Geriatric Medicine, Tokyo Medical University
  • Oyama Tetsuo
    Department of Geriatric Medicine, Tokyo Medical University Department of Internal Medicine, Tachikawa Medical Center, Yuyukenkoumura Hospital
  • Ogawa Kimikazu
    Department of Geriatric Medicine, Tokyo Medical University Department of Internal Medicine, Tachikawa Medical Center, Yuyukenkoumura Hospital
  • Fukutomi Atsushi
    Third Department of Internal Medicine, Tokyo Medical University Department of Internal Medicine, Tachikawa Medical Center, Yuyukenkoumura Hospital
  • Arai Hisayuki
    Department of Geriatric Medicine, Tokyo Medical University Department of Internal Medicine, Tachikawa Medical Center, Yuyukenkoumura Hospital
  • Katsunuma Hideyo
    Department of Internal Medicine, Tachikawa Medical Center, Yuyukenkoumura Hospital
  • Iwamoto Toshihiko
    Department of Geriatric Medicine, Tokyo Medical University
  • Takasaki Masaru
    Department of Geriatric Medicine, Tokyo Medical University

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Other Title
  • 急速に進行した呼吸不全に対し非侵襲的陽圧呼吸（ＮＩＰＰＶ）が有効であった高齢者Ａ型インフルエンザ肺炎の１例

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Abstract

A 79-year-old woman was admitted on January 18, 2000, with a lumbar compression fracture. Two days after admission, a chest X-ray film showed reticular infiltrates in the right lung field. She was diagnosed as having pneumonia and was treated with antibiotics. Despite this therapy, her symptoms did not improve and the infiltrates diffusely extended to involve both lungs on chest X-ray films. She was placed on noninvasive positive pressure ventilation (NIPPV) for progressive respiratory failure at 5 days after admission in order to avoid endotracheal intubation. Her hypoxemia was immediately improved by oronasal bilevel positive airway pressure ventilation (BiPAP) and chest X-ray films revealed improvement of the reticular infiltrates. Measurement of viral antibody titers showed that the cause of acute respiratory failure was influenza A virus pneumonia. In conclusion, NIPPV may reduce the need for intubation of elderly patients with acute respiratory failure, as well as chronic obstructive pulmonary disease (COPD) patients.

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