A 45-year-old previously healthy female presents to the emer…
A 45-year-old previously healthy female presents to the emergency department with 3 days of fevers and progressive dyspnea and is admitted to the intensive care unit (ICU) for influenza infection complicated by severe hypoxemia. She is intubated, and chest radiograph following intubation demonstrates an appropriately placed endotracheal tube with bilateral patchy opacities and interstitial markings throughout all lung fields, without effusions. Her bedside echocardiogram reveals a left ventricular ejection fraction of 0.75 with otherwise normal findings. Her ventilator settings are volume control, tidal volume (VT) 500 mL, respiratory rate (RR) 14 breaths per minute, FiO2 1.0, and positive end-expiratory pressure (PEEP) 5 cm H2O. An initial arterial blood gas (ABG) is pH 7.30 PCO2 45 mm Hg and PO2 80 mm Hg. Which of the following therapies has been best shown to improve the survival of patients such as this woman?