The authors describe the case of a 61-year-old woman who was admitted to our intensive care unit (ICU) due to impaired consciousness associated with generalised seizures. Her cerebrospinal fluid, electrolytes, acid-base analysis, and common laboratory and toxicology tests were normal. An MRI ruled out the presence of stroke or haemorrhage but showed severe leukoencephalopathy. Parkinson's disease, Creuzfeld-Jacob disease, vascular alterations, cancer, and rheumatological and metabolic diseases were evaluated and excluded. In view of her history of hypothyroidism despite adequate hormonal replacement and clinical behaviour, Hashimoto's encephalopathy was considered. Anti-thyroperoxidase levels were above 3000 IU/ml. The patient received 5 g of methylprednisolone followed by prednisone, but after a favourable initial response, returned to a comatose state. However, after administration of intravenous immunoglobulin (IVIG) 2 g/kg, the patient recovered with resolution of neurological symptoms and was discharged from the ICU 4 days after finishing IVIG treatment.

Management of patients with severe respiratory failure is mainly supportive, and protective mechanical ventilation is the pivotal treatment. When conventional therapy is insufficient to improve oxygenation without deleterious effects, other strategies should be considered. We report a 53 year-old male who presented a severe respiratory failure refractory to conventional management after pneumonectomy. Prone position ventilation was used for 36 hours. Respiratory variables improved and he did not show hemodynamic instability. He was returned to the supine position without worsening of oxygenation parameters. Extended prone position ventilation could be considered in patients presenting with unresponsive severe respiratory failure after pulmonary resection.

Prolonged prone position ventilation for severe respiratory distress syndrome post-pneumonectomy. Report of one caseManagement of patients with severe respiratory failure is mainly supportive, and protective mechanical ventilation is the pivotal treatment.When conventional therapy is insufficient to improve oxygenation without deleterious effects, other strategies should be considered.We report a 53 year-old male who presented a severe respiratory failure refractory to conventional management after pneumonectomy.Prone position ventilation was used for 36 hours.Respiratory variables improved and he did not show hemodynamic instability.He was returned to the supine position without worsening of oxygenation parameters.Extended prone position ventilation could be considered in patients presenting with unresponsive severe respiratory failure after pulmonary resection (Rev Méd Chile 2009;

Introduction: During pandemic for influenza A(H1N1), Chile achieved one of the highest rates of infection worldwide. On 2009 and 2010, our hospital received a large number of infected patients. We evaluated the impact of extended prone position ventilation (PPV) on respiratory variables from severe ARDS patients secondary to this influenza. We also compared these results with those obtai