Successfull High PEEP Application in a Pregnant Woman with ARDS Diagnosed with H1N1 Virus Infection

A seven-month pregnant woman who admitted to the hospital with high fever, cough and fatigue and developed respiratory failure within one day, was admitted to the intensive care unit with the diagnosis of acute respiratory distress syndrome (ARDS) and suspected H1N1 infection. The patient, who had bilateral infiltration on her chest X-ray, did not respond to the ventilator adjustments appropriate to ARDS, empirical Oseltamivir treatment. In spite of this treatment, her oxygenation became worse and she was treated by caesarean section. When the patient’s saturation fell to 35%, 18 cmH2O pressure PEEP was implemented, then it was observed that her oxygenation began to show improvement. The patient’s initial H1N1 diagnosis was confirmed. The patient’s overall health returned to normal, while no serious health problem was observed in the baby. Since pregnant patients with H1N1 may develop serious respiratory failure within a very short time, we found this report significant because lung expansion may increase with section and this condition assists the treatment of using high PEEP pressures.