Eleven questions on Hantavirus cardiopulmonary syndrome management in the ICU

Abstract

Hantavirus cardiopulmonary syndrome (HCPS) due to Andes virus (ANDV) is a fulminant yet potentially reversible cause of respiratory and circulatory failure requiring timely critical care. This article addresses eleven practical questions on ICU management, drawing on clinical experience and research from the Chilean healthcare system. The recommendations cover early recognition, diagnostic workup, haemodynamic monitoring, cautious fluid and vasoactive support, respiratory management, VA-ECMO referral, daily ICU care, recovery, common pitfalls, and therapies with limited evidence. Because no antiviral or immunomodulatory therapy has consistently improved outcomes, survival relies on early suspicion, physiology-guided supportive care, and rapid escalation to ECMO-capable centres when severe cardiopulmonary failure develops.