Clinical observation and nursing care of 32 cases with severe influenza A (H1N1) infection

Abstract

Objective To summarize the treatment and nursing care of critically ill patients with A (H1N1) influenza infection.Methods 32 cases with severe influenza A (H1N1) infection were ventilated with synchronized intermittent mandatory ventilation pressure mode (SIMV + PSV + PEEP) ,PEEP and FiO2 were titrated to get the optimal oxygenation and tidal volume was controled within 6-8 ml/kg,PEEP ≤20 cm H2O,plateau pressure ≤35 cm H2O.Heart rate,blood pressure,oxygen saturation were recorded every two hours;Rightand left lying position were alternately conducted every 2 hours;lung recruitment (LR) was performed every when sputum suction was done;arterial blood gas analysis,C-reactive protein,coagulation parameters,liver function,renal function,myocardial enzyme test were checked daily and also chest X-ray examination.Results Of 32 patients,26 improved in oxygenation index,and were weaned off successfully,6 patients died of refractory hypoxemia.Conclusion Severe influenza A (H1N1) infection patients should be treated with oseltamivir as soon as possible.The implementation of lung protective ventilation strategy,close observation of vital signs,timely monitoring of laboratory tests,taking prone position ventilation reducing the frequency of sputum suction are most important. Key words: Severe Influenza AH1N1; Lung protective ventilation; Prone ventilation; Nursing