Extracorporeal Membrane Oxygenation for Fulminant Influenza Pneumonia

Abstract

A 48-year-old healthy man developed diffuse pneumonia with refractory hypoxemia. Sputum cultures were negative for bacterial pathogens. Myxovirus particles were demonstrated by electronmicroscopy in the tracheal aspirate reflecting the high infectivity titer of the sputum. Positive end-expiratory pressure ventilation and ten days of extracorporeal membrane oxygenation were utilized to maintain the inspired oxygen concentration at 70 percent or less in an effort to prevent oxygen-induced lung damage. Despite these therapeutic and supportive measures, progressive pulmonary fibrosis ensued precluding the patient’s survival. This case demonstrated that the pulmonary parenchymal change produced by fulminant influenza pneumonia may not be reversible even during prolonged maintenance of adequate arterial oxygen tension with an extracorporeal oxygenator. A 48-year-old healthy man developed diffuse pneumonia with refractory hypoxemia. Sputum cultures were negative for bacterial pathogens. Myxovirus particles were demonstrated by electronmicroscopy in the tracheal aspirate reflecting the high infectivity titer of the sputum. Positive end-expiratory pressure ventilation and ten days of extracorporeal membrane oxygenation were utilized to maintain the inspired oxygen concentration at 70 percent or less in an effort to prevent oxygen-induced lung damage. Despite these therapeutic and supportive measures, progressive pulmonary fibrosis ensued precluding the patient’s survival. This case demonstrated that the pulmonary parenchymal change produced by fulminant influenza pneumonia may not be reversible even during prolonged maintenance of adequate arterial oxygen tension with an extracorporeal oxygenator.