Virus-associated hemophagocytic syndrome as a major contributor to death in patients with 2009 influenza A (H1N1) infection.
Identifieur interne : 000279 ( Main/Exploration ); précédent : 000278; suivant : 000280Virus-associated hemophagocytic syndrome as a major contributor to death in patients with 2009 influenza A (H1N1) infection.
Auteurs : Gernot Beutel [Allemagne] ; Olaf Wiesner ; Matthias Eder ; Carsten Hafer ; Andrea S. Schneider ; Jan T. Kielstein ; Christian Kühn ; Albert Heim ; Tina Ganzenmüller ; Hans-Heinrich Kreipe ; Axel Haverich ; Andreas Tecklenburg ; Arnold Ganser ; Tobias Welte ; Marius M. HoeperSource :
- Critical care (London, England) [ 1466-609X ] ; 2011.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Allemagne (épidémiologie), Femelle (MeSH), Grippe humaine (mortalité), Humains (MeSH), Indice de gravité de la maladie (MeSH), Lymphohistiocytose hémophagocytaire (mortalité), Maladie grave (MeSH), Mâle (MeSH), Sous-type H1N1 du virus de la grippe A (MeSH), Études prospectives (MeSH).
- MESH :
- mortalité : Grippe humaine, Lymphohistiocytose hémophagocytaire.
- épidémiologie : Allemagne.
- Adulte, Adulte d'âge moyen, Femelle, Humains, Indice de gravité de la maladie, Maladie grave, Mâle, Sous-type H1N1 du virus de la grippe A, Études prospectives.
- Wicri :
- geographic : Allemagne.
English descriptors
- KwdEn :
- Adult (MeSH), Critical Illness (MeSH), Female (MeSH), Germany (epidemiology), Humans (MeSH), Influenza A Virus, H1N1 Subtype (MeSH), Influenza, Human (mortality), Lymphohistiocytosis, Hemophagocytic (mortality), Male (MeSH), Middle Aged (MeSH), Prospective Studies (MeSH), Severity of Illness Index (MeSH).
- MESH :
- geographic , epidemiology : Germany.
- mortality : Influenza, Human, Lymphohistiocytosis, Hemophagocytic.
- Adult, Critical Illness, Female, Humans, Influenza A Virus, H1N1 Subtype, Male, Middle Aged, Prospective Studies, Severity of Illness Index.
Abstract
INTRODUCTION
Virus-associated hemophagocytic syndrome (VAHS) is a severe complication of various viral infections often resulting in multiorgan failure and death. The purpose of this study was to describe baseline characteristics, development of VAHS, related treatments and associated mortality rate of consecutive critically ill patients with confirmed 2009 influenza A (H1N1) infection and respiratory failure.
METHODS
We conducted a prospective observational study of 25 critically ill patients with 2009 influenza A (H1N1) infection at a single-center intensive care unit in Germany between 5 October 2009 and 4 January 2010. Demographic data, comorbidities, diagnosis of VAHS, illness progression, treatments and survival data were collected. The primary outcome measure was the development of VAHS and related mortality. Secondary outcome variables included duration of mechanical ventilation, support of extracorporeal membrane oxygenation and duration of viral shedding.
RESULTS
VAHS developed in 9 (36%) of 25 critically ill patients with confirmed 2009 influenza A (H1N1) infection, and 8 (89%) of them died. In contrast, the mortality rate in the remaining 16 patients without VAHS was 25% (P = 0.004 for the survival difference in patients with or without VAHS by log-rank analysis). The patients were relatively young (median age, 45 years; interquartile range (IQR), 35 to 56 years of age); however, 18 patients (72%) presented with one or more risk factors for a severe course of illness. All 25 patients received mechanical ventilation for severe acute respiratory distress syndrome and refractory hypoxemia, with a median duration of mechanical ventilation of 19 days (IQR, 13 to 26 days). An additional 17 patients (68%) required extracorporeal membrane oxygenation for a median of 10 days (IQR, 6 to 19 days).
CONCLUSIONS
The findings of this study raise the possibility that VAHS may be a frequent complication of severe 2009 influenza A (H1N1) infection and represents an important contributor to multiorgan failure and death.
DOI: 10.1186/cc10073
PubMed: 21366922
PubMed Central: PMC3219333
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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Kielstein</name></author><author><name sortKey="Kuhn, Christian" sort="Kuhn, Christian" uniqKey="Kuhn C" first="Christian" last="Kühn">Christian Kühn</name></author><author><name sortKey="Heim, Albert" sort="Heim, Albert" uniqKey="Heim A" first="Albert" last="Heim">Albert Heim</name></author><author><name sortKey="Ganzenmuller, Tina" sort="Ganzenmuller, Tina" uniqKey="Ganzenmuller T" first="Tina" last="Ganzenmüller">Tina Ganzenmüller</name></author><author><name sortKey="Kreipe, Hans Heinrich" sort="Kreipe, Hans Heinrich" uniqKey="Kreipe H" first="Hans-Heinrich" last="Kreipe">Hans-Heinrich Kreipe</name></author><author><name sortKey="Haverich, Axel" sort="Haverich, Axel" uniqKey="Haverich A" first="Axel" last="Haverich">Axel Haverich</name></author><author><name sortKey="Tecklenburg, Andreas" sort="Tecklenburg, Andreas" uniqKey="Tecklenburg A" first="Andreas" last="Tecklenburg">Andreas Tecklenburg</name></author><author><name sortKey="Ganser, Arnold" sort="Ganser, Arnold" uniqKey="Ganser A" first="Arnold" last="Ganser">Arnold Ganser</name></author><author><name sortKey="Welte, Tobias" sort="Welte, Tobias" uniqKey="Welte T" first="Tobias" last="Welte">Tobias Welte</name></author><author><name sortKey="Hoeper, Marius M" sort="Hoeper, Marius M" uniqKey="Hoeper M" first="Marius M" last="Hoeper">Marius M. 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Beutel.Gernot@mh-hannover.de</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Departments of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Carl-Neuberg-Strasse 1, D-30625 Hannover</wicri:regionArea><placeName><region type="land" nuts="2">Basse-Saxe</region><settlement type="city">Hanovre</settlement></placeName></affiliation></author><author><name sortKey="Wiesner, Olaf" sort="Wiesner, Olaf" uniqKey="Wiesner O" first="Olaf" last="Wiesner">Olaf Wiesner</name></author><author><name sortKey="Eder, Matthias" sort="Eder, Matthias" uniqKey="Eder M" first="Matthias" last="Eder">Matthias Eder</name></author><author><name sortKey="Hafer, Carsten" sort="Hafer, Carsten" uniqKey="Hafer C" first="Carsten" last="Hafer">Carsten Hafer</name></author><author><name sortKey="Schneider, Andrea S" sort="Schneider, Andrea S" uniqKey="Schneider A" first="Andrea S" last="Schneider">Andrea S. Schneider</name></author><author><name sortKey="Kielstein, Jan T" sort="Kielstein, Jan T" uniqKey="Kielstein J" first="Jan T" last="Kielstein">Jan T. Kielstein</name></author><author><name sortKey="Kuhn, Christian" sort="Kuhn, Christian" uniqKey="Kuhn C" first="Christian" last="Kühn">Christian Kühn</name></author><author><name sortKey="Heim, Albert" sort="Heim, Albert" uniqKey="Heim A" first="Albert" last="Heim">Albert Heim</name></author><author><name sortKey="Ganzenmuller, Tina" sort="Ganzenmuller, Tina" uniqKey="Ganzenmuller T" first="Tina" last="Ganzenmüller">Tina Ganzenmüller</name></author><author><name sortKey="Kreipe, Hans Heinrich" sort="Kreipe, Hans Heinrich" uniqKey="Kreipe H" first="Hans-Heinrich" last="Kreipe">Hans-Heinrich Kreipe</name></author><author><name sortKey="Haverich, Axel" sort="Haverich, Axel" uniqKey="Haverich A" first="Axel" last="Haverich">Axel Haverich</name></author><author><name sortKey="Tecklenburg, Andreas" sort="Tecklenburg, Andreas" uniqKey="Tecklenburg A" first="Andreas" last="Tecklenburg">Andreas Tecklenburg</name></author><author><name sortKey="Ganser, Arnold" sort="Ganser, Arnold" uniqKey="Ganser A" first="Arnold" last="Ganser">Arnold Ganser</name></author><author><name sortKey="Welte, Tobias" sort="Welte, Tobias" uniqKey="Welte T" first="Tobias" last="Welte">Tobias Welte</name></author><author><name sortKey="Hoeper, Marius M" sort="Hoeper, Marius M" uniqKey="Hoeper M" first="Marius M" last="Hoeper">Marius M. Hoeper</name></author></analytic><series><title level="j">Critical care (London, England)</title><idno type="eISSN">1466-609X</idno><imprint><date when="2011" type="published">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Critical Illness (MeSH)</term><term>Female (MeSH)</term><term>Germany (epidemiology)</term><term>Humans (MeSH)</term><term>Influenza A Virus, H1N1 Subtype (MeSH)</term><term>Influenza, Human (mortality)</term><term>Lymphohistiocytosis, Hemophagocytic (mortality)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Prospective Studies (MeSH)</term><term>Severity of Illness Index (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Allemagne (épidémiologie)</term><term>Femelle (MeSH)</term><term>Grippe humaine (mortalité)</term><term>Humains (MeSH)</term><term>Indice de gravité de la maladie (MeSH)</term><term>Lymphohistiocytose hémophagocytaire (mortalité)</term><term>Maladie grave (MeSH)</term><term>Mâle (MeSH)</term><term>Sous-type H1N1 du virus de la grippe A (MeSH)</term><term>Études prospectives (MeSH)</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Germany</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Influenza, Human</term><term>Lymphohistiocytosis, Hemophagocytic</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Grippe humaine</term><term>Lymphohistiocytose hémophagocytaire</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Allemagne</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Critical Illness</term><term>Female</term><term>Humans</term><term>Influenza A Virus, H1N1 Subtype</term><term>Male</term><term>Middle Aged</term><term>Prospective Studies</term><term>Severity of Illness Index</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Indice de gravité de la maladie</term><term>Maladie grave</term><term>Mâle</term><term>Sous-type H1N1 du virus de la grippe A</term><term>Études prospectives</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Allemagne</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>INTRODUCTION</b></p><p>Virus-associated hemophagocytic syndrome (VAHS) is a severe complication of various viral infections often resulting in multiorgan failure and death. The purpose of this study was to describe baseline characteristics, development of VAHS, related treatments and associated mortality rate of consecutive critically ill patients with confirmed 2009 influenza A (H1N1) infection and respiratory failure.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>We conducted a prospective observational study of 25 critically ill patients with 2009 influenza A (H1N1) infection at a single-center intensive care unit in Germany between 5 October 2009 and 4 January 2010. Demographic data, comorbidities, diagnosis of VAHS, illness progression, treatments and survival data were collected. The primary outcome measure was the development of VAHS and related mortality. Secondary outcome variables included duration of mechanical ventilation, support of extracorporeal membrane oxygenation and duration of viral shedding.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>VAHS developed in 9 (36%) of 25 critically ill patients with confirmed 2009 influenza A (H1N1) infection, and 8 (89%) of them died. In contrast, the mortality rate in the remaining 16 patients without VAHS was 25% (P = 0.004 for the survival difference in patients with or without VAHS by log-rank analysis). The patients were relatively young (median age, 45 years; interquartile range (IQR), 35 to 56 years of age); however, 18 patients (72%) presented with one or more risk factors for a severe course of illness. All 25 patients received mechanical ventilation for severe acute respiratory distress syndrome and refractory hypoxemia, with a median duration of mechanical ventilation of 19 days (IQR, 13 to 26 days). An additional 17 patients (68%) required extracorporeal membrane oxygenation for a median of 10 days (IQR, 6 to 19 days).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>The findings of this study raise the possibility that VAHS may be a frequent complication of severe 2009 influenza A (H1N1) infection and represents an important contributor to multiorgan failure and death.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">21366922</PMID><DateCompleted><Year>2011</Year><Month>12</Month><Day>07</Day></DateCompleted><DateRevised><Year>2018</Year><Month>11</Month><Day>13</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1466-609X</ISSN><JournalIssue CitedMedium="Internet"><Volume>15</Volume><Issue>2</Issue><PubDate><Year>2011</Year></PubDate></JournalIssue><Title>Critical care (London, England)</Title><ISOAbbreviation>Crit Care</ISOAbbreviation></Journal><ArticleTitle>Virus-associated hemophagocytic syndrome as a major contributor to death in patients with 2009 influenza A (H1N1) infection.</ArticleTitle><Pagination><MedlinePgn>R80</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/cc10073</ELocationID><Abstract><AbstractText Label="INTRODUCTION" NlmCategory="BACKGROUND">Virus-associated hemophagocytic syndrome (VAHS) is a severe complication of various viral infections often resulting in multiorgan failure and death. The purpose of this study was to describe baseline characteristics, development of VAHS, related treatments and associated mortality rate of consecutive critically ill patients with confirmed 2009 influenza A (H1N1) infection and respiratory failure.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We conducted a prospective observational study of 25 critically ill patients with 2009 influenza A (H1N1) infection at a single-center intensive care unit in Germany between 5 October 2009 and 4 January 2010. Demographic data, comorbidities, diagnosis of VAHS, illness progression, treatments and survival data were collected. The primary outcome measure was the development of VAHS and related mortality. Secondary outcome variables included duration of mechanical ventilation, support of extracorporeal membrane oxygenation and duration of viral shedding.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">VAHS developed in 9 (36%) of 25 critically ill patients with confirmed 2009 influenza A (H1N1) infection, and 8 (89%) of them died. In contrast, the mortality rate in the remaining 16 patients without VAHS was 25% (P = 0.004 for the survival difference in patients with or without VAHS by log-rank analysis). The patients were relatively young (median age, 45 years; interquartile range (IQR), 35 to 56 years of age); however, 18 patients (72%) presented with one or more risk factors for a severe course of illness. All 25 patients received mechanical ventilation for severe acute respiratory distress syndrome and refractory hypoxemia, with a median duration of mechanical ventilation of 19 days (IQR, 13 to 26 days). An additional 17 patients (68%) required extracorporeal membrane oxygenation for a median of 10 days (IQR, 6 to 19 days).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">The findings of this study raise the possibility that VAHS may be a frequent complication of severe 2009 influenza A (H1N1) infection and represents an important contributor to multiorgan failure and death.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Beutel</LastName><ForeName>Gernot</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Departments of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany. Beutel.Gernot@mh-hannover.de</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wiesner</LastName><ForeName>Olaf</ForeName><Initials>O</Initials></Author><Author ValidYN="Y"><LastName>Eder</LastName><ForeName>Matthias</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Hafer</LastName><ForeName>Carsten</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Schneider</LastName><ForeName>Andrea S</ForeName><Initials>AS</Initials></Author><Author ValidYN="Y"><LastName>Kielstein</LastName><ForeName>Jan T</ForeName><Initials>JT</Initials></Author><Author ValidYN="Y"><LastName>Kühn</LastName><ForeName>Christian</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Heim</LastName><ForeName>Albert</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Ganzenmüller</LastName><ForeName>Tina</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><LastName>Kreipe</LastName><ForeName>Hans-Heinrich</ForeName><Initials>HH</Initials></Author><Author ValidYN="Y"><LastName>Haverich</LastName><ForeName>Axel</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Tecklenburg</LastName><ForeName>Andreas</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Ganser</LastName><ForeName>Arnold</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Welte</LastName><ForeName>Tobias</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><LastName>Hoeper</LastName><ForeName>Marius M</ForeName><Initials>MM</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2011</Year><Month>03</Month><Day>02</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Crit Care</MedlineTA><NlmUniqueID>9801902</NlmUniqueID><ISSNLinking>1364-8535</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Crit Care. 2011;15(5):440</RefSource><PMID Version="1">21923958</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016638" MajorTopicYN="N">Critical Illness</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005858" MajorTopicYN="N" Type="Geographic">Germany</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D053118" 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first="Axel" last="Haverich">Axel Haverich</name><name sortKey="Heim, Albert" sort="Heim, Albert" uniqKey="Heim A" first="Albert" last="Heim">Albert Heim</name><name sortKey="Hoeper, Marius M" sort="Hoeper, Marius M" uniqKey="Hoeper M" first="Marius M" last="Hoeper">Marius M. Hoeper</name><name sortKey="Kielstein, Jan T" sort="Kielstein, Jan T" uniqKey="Kielstein J" first="Jan T" last="Kielstein">Jan T. Kielstein</name><name sortKey="Kreipe, Hans Heinrich" sort="Kreipe, Hans Heinrich" uniqKey="Kreipe H" first="Hans-Heinrich" last="Kreipe">Hans-Heinrich Kreipe</name><name sortKey="Kuhn, Christian" sort="Kuhn, Christian" uniqKey="Kuhn C" first="Christian" last="Kühn">Christian Kühn</name><name sortKey="Schneider, Andrea S" sort="Schneider, Andrea S" uniqKey="Schneider A" first="Andrea S" last="Schneider">Andrea S. Schneider</name><name sortKey="Tecklenburg, Andreas" sort="Tecklenburg, Andreas" uniqKey="Tecklenburg A" first="Andreas" last="Tecklenburg">Andreas Tecklenburg</name><name sortKey="Welte, Tobias" sort="Welte, Tobias" uniqKey="Welte T" first="Tobias" last="Welte">Tobias Welte</name><name sortKey="Wiesner, Olaf" sort="Wiesner, Olaf" uniqKey="Wiesner O" first="Olaf" last="Wiesner">Olaf Wiesner</name></noCountry><country name="Allemagne"><region name="Basse-Saxe"><name sortKey="Beutel, Gernot" sort="Beutel, Gernot" uniqKey="Beutel G" first="Gernot" last="Beutel">Gernot Beutel</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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