Respiratory support during the influenza A (H1N1) pandemic flu in Sweden
Identifieur interne : 001273 ( Istex/Curation ); précédent : 001272; suivant : 001274Respiratory support during the influenza A (H1N1) pandemic flu in Sweden
Auteurs : M. Brink [Suède] ; L. Hagberg [Suède] ; A. Larsson [Suède] ; R. Gedeborg [Suède]Source :
- Acta Anaesthesiologica Scandinavica [ 0001-5172 ] ; 2012-09.
English descriptors
- Teeft :
- Acute lung, Acute physiology score, Adult patients, Adverse outcome, Antibiotic, Arterial blood, Arterial blood pressure, Arterial oxygen saturation, Authors acta anaesthesiologica scandinavica, Baseline characteristics, Blood gases, Body mass index, Bone marrow transplant, Cardiovascular disease, Chronic morbidity, Clinical practice, Corticosteroid, Corticosteroid treatment, Crit, Crit care, Critical illness, Death survival, Diabetes mellitus, Distress syndrome, Early report, Ecmo, Emergency department, Euro surveill, Extracorporeal membrane oxygenation, Fio2, Haematological malignancy, Heart failure, Higher mortality, Higher prevalence, Hospital admission, Ideal body weight, Inhalation, Inotropes corticosteroids dialysis, Intensive care, Intensive care unit, Intensive care unit admission, Intensive care units, Interquartile, Interquartile range, Intubated, Intubation, Invasive, Invasive ventilation, June, Lung injury, Lung quadrants, Mechanical ventilation, Median, Median time, Mmhg, Mortality rate, Mortality risk, Muscle relaxation, National board, Neuromuscular disease, Nitric oxide inhalation, Noninvasive, Noninvasive ventilation, Nonsurvivors, Organ failure score, Oseltamivir, Oseltamivir antibiotics vasopressors, Pandemic, Pandemic phase, Pao2, Partial pressure, Patient characteristics, Prostacycline inhalation, Pulmonary barotrauma, Pulmonary disease diabetes mellitus haematological malignancy, Pulse oxymetry, Relative risk, Rescue therapies, Rescue therapy, Rescue therapy nitric oxide prostacycline, Respir crit care, Respiratory failure, Respiratory rescue therapies, Respiratory support, Respiratory support strategy, Respiratory syndrome, Risk factors, Sahlgrenska academy, Same magnitude, Study patients, Supplementary oxygen, Support strategy, Sweden table, Swedish association, Swedish icus, Swedish institute, Syndrome, Tidal volume, Uppsala university, Ventilation, Ventilatory support.
Abstract
Background: Acute respiratory insufficiency characterised critically ill patients during the influenza A (H1N1) pandemic 2009–2010. Detailed understanding of disease progression and outcome in relation to different respiratory support strategies is important. Methods: Data collected between August 2009 and February 2010 for a national intensive care unit influenza registry were combined with cases identified by the Swedish Institute for Infectious Disease Control. Results: Clinical data was available for 95% (126/136) of the critically ill cases of influenza. Median age was 44 years, and major co‐morbidities were present in 41%. Respiratory support strategies were studied among the 110 adult patients. Supplementary oxygen was sufficient in 15% (16), non‐invasive ventilation (NIV) only was used in 20% (22), while transition from NIV to invasive ventilation (IV) was seen in 41% (45). IV was initiated directly in 24% (26). Patients initially treated with NIV had a higher arterial partial pressure of oxygen/fraction of oxygen in inspired gas ratio compared with those primarily treated with IV. Major baseline characteristics and 28‐day mortality were similar, but 90‐day mortality was higher in patients initially treated with NIV 17/67 (25%) as compared with patients primarily treated with IV 3/26 (12%), relative risk 1.2 (95% confidence interval 0.3–4.0). Conclusions: Critical illness because of 2009 influenza A (H1N1) in Sweden was dominated by hypoxic respiratory failure. The majority of patients in need of respiratory support were initially treated with NIV. In spite of less severe initial hypoxemia, initiation of ventilatory support with NIV was not associated with improved outcome.
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DOI: 10.1111/j.1399-6576.2012.02727.x
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Detailed understanding of disease progression and outcome in relation to different respiratory support strategies is important. Methods: Data collected between August 2009 and February 2010 for a national intensive care unit influenza registry were combined with cases identified by the Swedish Institute for Infectious Disease Control. Results: Clinical data was available for 95% (126/136) of the critically ill cases of influenza. Median age was 44 years, and major co‐morbidities were present in 41%. Respiratory support strategies were studied among the 110 adult patients. Supplementary oxygen was sufficient in 15% (16), non‐invasive ventilation (NIV) only was used in 20% (22), while transition from NIV to invasive ventilation (IV) was seen in 41% (45). IV was initiated directly in 24% (26). Patients initially treated with NIV had a higher arterial partial pressure of oxygen/fraction of oxygen in inspired gas ratio compared with those primarily treated with IV. Major baseline characteristics and 28‐day mortality were similar, but 90‐day mortality was higher in patients initially treated with NIV 17/67 (25%) as compared with patients primarily treated with IV 3/26 (12%), relative risk 1.2 (95% confidence interval 0.3–4.0). Conclusions: Critical illness because of 2009 influenza A (H1N1) in Sweden was dominated by hypoxic respiratory failure. The majority of patients in need of respiratory support were initially treated with NIV. In spite of less severe initial hypoxemia, initiation of ventilatory support with NIV was not associated with improved outcome.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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