Recovery of pulmonary functions, exercise capacity, and quality of life after pulmonary rehabilitation in survivors of ARDS due to severe influenza A (H1N1) pneumonitis

Influenza Other Respir Viruses. 2018 Sep;12(5):643-648. doi: 10.1111/irv.12566. Epub 2018 Jun 12.


Background: Acute respiratory distress syndrome (ARDS) due to severe influenza A H1N1 pneumonitis would result in impaired pulmonary functions and health-related quality of life (HRQoL) after hospital discharge.

Objectives: The recovery of pulmonary functions, exercise capacity, and HRQoL in the survivors of ARDS due to 2009 pandemic influenza A H1N1 pneumonitis (H1N1-ARDS) was evaluated in a tertiary teaching hospital in northern Taiwan between May 2010 and June 2011.

Patients and methods: Data of spirometry, total lung capacity (TLC), diffusing capacity of carbon monoxide (DLCO ), and 6-minute walk distance (6MWD) in the patients survived from H1N1-ARDS were collected 1, 3, and 6 months post-hospital discharge. HRQoL was evaluated with St. George respiratory questionnaire (SGRQ).

Results: Nine survivors of H1N1-ARDS in the study period were included. All these patients received 2 months' pulmonary rehabilitation program. Pulmonary functions and exercise capacity included TLC, forced vital capacity (FVC), forced expiratory volume in the first second (FEV1 ), DLCO , and 6MWD improved from 1 to 3 months post-hospital discharge. Only TLC had further significant improvement from 3 to 6 months. HRQoL represented as the total score of SGRQ had no significant improvement in the first 3 months but improved significantly from 3 to 6 months post-discharge.

Conclusion: The impaired pulmonary functions and exercise capacity in the survivors of H1N1-ARDS improved soon at 3 months after hospital discharge. Their quality of life had keeping improved at 6 months even though there was no further improvement of their pulmonary functions and exercise capacity.

Keywords: acute respiratory distress syndrome; exercise capacity; influenza A H1N1; pulmonary function tests; quality of life.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Influenza A Virus, H1N1 Subtype / isolation & purification*
  • Influenza, Human / complications
  • Influenza, Human / pathology*
  • Influenza, Human / virology
  • Lung / physiology*
  • Male
  • Middle Aged
  • Pneumonia / complications
  • Pneumonia / pathology*
  • Pneumonia / virology
  • Quality of Life*
  • Respiratory Distress Syndrome / pathology*
  • Respiratory Function Tests*
  • Taiwan
  • Tertiary Care Centers
  • Time Factors
  • Treatment Outcome
  • Young Adult