Identifier to cite or link to this item: http://hdl.handle.net/20.500.13003/16845
Intensive care adult patients with severe respiratory failure caused by Influenza A (H1N1)v in Spain
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AuthorRello, Jordi; Rodriguez, Alejandro; Ibanez, Pedro; Socias Crespi, Lorenzo ; Cebrian, Javier; Marques, Asuncion; Guerrero, Jose ; Ruiz-Santana, Sergio; Marquez, Enrique; Del Nogal-Saez, Frutos; Alvarez-Lerma, Francisco; Martinez, Sergio; Ferrer, Miquel; Avellanas, Manuel; Granada, Rosa; Maravi-Poma, Enrique; Albert, Patricia; Sierra, Rafael; Vidaur, Loreto; Ortiz, Patricia; Prieto del Portillo, Isidro; Galvan, Beatriz; Leon-Gil, Cristobal; H1N1 SEMICYUC Working Grp
Document typeresearch article
CitationRello J, Rodriguez A, Ibanez P, Socias L, Cebrian J, Marques A, et al. Intensive care adult patients with severe respiratory failure caused by Influenza A (H1N1)v in Spain. Crit Care. 2009;13(5):R148. Epub 2009 Sep 11.
Introduction Patients with influenza A (H1N1)v infection have developed rapidly progressive lower respiratory tract disease resulting in respiratory failure. We describe the clinical and epidemiologic characteristics of the first 32 persons reported to be admitted to the intensive care unit (ICU) due to influenza A (H1N1)v infection in Spain. Methods We used medical chart reviews to collect data on ICU adult patients reported in a standardized form. Influenza A (H1N1)v infection was confirmed in specimens using real-time reverse transcriptase-polymerase-chain-reaction (RT PCR) assay. Results Illness onset of the 32 patients occurred between 23 June and 31 July, 2009. The median age was 36 years (IQR = 31 - 52). Ten (31.2%) were obese, 2 (6.3%) pregnant and 16 (50%) had pre-existing medical complications. Twenty-nine (90.6%) had primary viral pneumonitis, 2 (6.3%) exacerbation of structural respiratory disease and 1 (3.1%) secondary bacterial pneumonia. Twenty-four patients (75.0%) developed multiorgan dysfunction, 7 (21.9%) received renal replacement techniques and 24 (75.0%) required mechanical ventilation. Six patients died within 28 days, with two additional late deaths. Oseltamivir administration delay ranged from 2 to 8 days after illness onset, 31.2% received high-dose (300 mg/day), and treatment duration ranged from 5 to 10 days (mean 8.0 +/- 3.3). Conclusions Over a 5-week period, influenza A (H1N1)v infection led to ICU admission in 32 adult patients, with frequently observed severe hypoxemia and a relatively high case-fatality rate. Clinicians should be aware of pulmonary complications of influenza A (H1N1)v infection, particularly in pregnant and young obese but previously healthy persons.
MeSHReverse Transcriptase Polymerase Chain Reaction
Severity of Illness Index
Influenza A Virus, H1N1 Subtype
Reacción en Cadena de la Polimerasa de Transcriptasa Inversa
Subtipo H1N1 del Virus de la Influenza A
Persona de Mediana Edad
Índice de Severidad de la Enfermedad