Influenza A: A Case Study

13-year-old female patient initially inpatient treated at a peripheral Children's Hospital with respiratory symptoms since a few days as part of an infection of the upper airways. Rapid respiratory worsening in the clinical course with the need for intubation. Influenza A was positively detected. During the intubation a temporary resuscitation was needed. Continuously increasing of catecholamine and ventilation requirements post intubation (PIP = 40 cmH2O, PEEP = 15 cmH2O, FiO2 = 100%). For an escalation of treatment due to the clinical presentation of fulminant septic shock due to the basis of an influenza infection (CrP 354 mg/l, Procalcitonin 3855 µg/l, Leukocytes 6,600/µl), the patient was taking over to our pediatric intensive care unit.
Detection of Influenza A in BALF and the detection of Staphylococcus aureus in blood cultures and tracheal secretions could be seen. Due to the severe Acute respiratory distress syndrome (ARDS), a slowly reduction of the ventilation parameters of the Extracorporeal membranous oxygen (ECMO) therapy could be possible. With continuous stabilization of the clinical situation and echocardiographically continuous improvement of the cardiac function a VA-ECMO weaning was done without any complications. Due to the initial severe ARDS followed by the persistent high ventilation parameters and oxygen demand in the clinical course, we switched to a VV-ECMO. Accompanying of a percutaneous dilated tracheostomy during the ventilation weaning was