Please use this identifier to cite or link to this item: http://hdl.handle.net/10553/45956
Title: Intensive care adult patients with severe respiratory failure caused by Influenza A (H1N1)v in Spain
Authors: Rello, Jordi
Rodríguez, Alejandro
Ibañez, Pedro
Socias, Lorenzo
Cebrian, Javier
Marques, Asunción
Guerrero, José
Ruiz-Santana, Sergio 
Marquez, Enrique
Del Nogal-Saez, Frutos
Alvarez-Lerma, Francisco
Martínez, Sergio
Ferrer, Miquel
Avellanas, Manuel
Granada, Rosa
Maraví-Poma, Enrique
Albert, Patricia
Sierra, Rafael
Vidaur, Loreto
Ortiz, Patricia
Prieto del Portillo, Isidro
Galván, Beatriz
León-Gil, Cristóbal
UNESCO Clasification: 32 Ciencias médicas
320505 Enfermedades infecciosas
Keywords: Chronic Obstructive Pulmonary Disease
Influenza
Intensive Care Unit Admission
Oseltamivir
Sequential Organ Failure Assessment Score
Issue Date: 2009
Journal: Critical Care 
Abstract: 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.
URI: http://hdl.handle.net/10553/45956
ISSN: 1364-8535
DOI: 10.1186/cc8044
Source: Critical Care [ISSN 1364-8535],v. 13 (R148)
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