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Introduction. Novel swine-origin influenza A (HlNl) was first reported in Mexico in April 2009 and rapidly spread to many countries around the world. Recent data indicate that the pandemic (H1N1) virus was the dominant influenza in most part of the world: since October 2O09, 191 countries reported more than 375OOO laboratory confirmed cases. World Health Organization (August 2010) reported as the most active pandenric HlNl areas India, New Zealand and Australia, with a decreasing incidence of new cases in the Northern hemisphere' In our ICU M patients were admitted with HLNl severe ARDS from Octobet iOOg to February 2010 and 15 patients fromJanuary to Februzry 2Oll. Lung CT scan is used to evaluate iniury morphologic pattern; according to CT appearance of severe LROS, our patients were classified in thtee groups: D dilfuse lf attenuations were evenly distributed throughout the lungs; 2) focal f damage had lobar or segmental distribution established on the recognition of anatomical structures such as the major fissure or the interlobular septa; 3) petchy if there were lobar or segmental areas of attenuation in some parts of the lungs but without recognized limits in others. As reported by Abbo, HlNl CT patterns of 21 patients from the first pandemic spread consisted in consolidatioo (43%; ground glass opaciry (38%) nodules (10%) and negative CT (8%).1