Estimates of the Demand for Mechanical Ventilation in the United States During an Influenza Pandemic
Identifieur interne : 001A13 ( Ncbi/Merge ); précédent : 001A12; suivant : 001A14Estimates of the Demand for Mechanical Ventilation in the United States During an Influenza Pandemic
Auteurs : Martin I. Meltzer ; Anita Patel ; Adebola Ajao ; Scott V. Nystrom ; Lisa M. Koonin [Géorgie (pays)]Source :
- Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America [ 1058-4838 ] ; 2015.
Descripteurs français
- KwdFr :
- Grippe humaine (), Grippe humaine (mortalité), Grippe humaine (épidémiologie), Humains, Modèles théoriques, Pandémies, Planification des mesures d'urgence en cas de catastrophe (), Respirateurs artificiels (ressources et distribution), Santé publique (), Sous-type H7N9 du virus de la grippe A (pathogénicité), Unités de soins intensifs (ressources et distribution), Ventilation artificielle (instrumentation), États-Unis d'Amérique (épidémiologie).
- MESH :
- mortalité : Grippe humaine.
- pathogénicité : Sous-type H7N9 du virus de la grippe A.
- ressources et distribution : Respirateurs artificiels, Unités de soins intensifs.
- épidémiologie : Grippe humaine, Ventilation artificielle, États-Unis d'Amérique.
- Grippe humaine, Humains, Modèles théoriques, Pandémies, Planification des mesures d'urgence en cas de catastrophe, Santé publique.
- Wicri :
- geographic : États-Unis.
English descriptors
- KwdEn :
- Disaster Planning (methods), Humans, Influenza A Virus, H7N9 Subtype (pathogenicity), Influenza, Human (epidemiology), Influenza, Human (mortality), Influenza, Human (therapy), Intensive Care Units (supply & distribution), Models, Theoretical, Pandemics, Public Health (methods), Respiration, Artificial (instrumentation), United States (epidemiology), Ventilators, Mechanical (supply & distribution).
- MESH :
- geographic , epidemiology : United States.
- epidemiology : Influenza, Human.
- instrumentation : Respiration, Artificial.
- methods : Disaster Planning, Public Health.
- mortality : Influenza, Human.
- pathogenicity : Influenza A Virus, H7N9 Subtype.
- supply & distribution : Intensive Care Units, Ventilators, Mechanical.
- therapy : Influenza, Human.
- Humans, Models, Theoretical, Pandemics.
Abstract
An outbreak in China in April 2013 of human illnesses due to avian influenza A(H7N9) virus provided reason for US public health officials to revisit existing national pandemic response plans. We built a spreadsheet model to examine the potential demand for invasive mechanical ventilation (excluding “rescue therapy” ventilation). We considered scenarios of either 20% or 30% gross influenza clinical attack rate (CAR), with a “low severity” scenario with case fatality rates (CFR) of 0.05%–0.1%, or a “high severity” scenario (CFR: 0.25%–0.5%). We used rates-of-influenza-related illness to calculate the numbers of potential clinical cases, hospitalizations, admissions to intensive care units, and need for mechanical ventilation. We assumed 10 days ventilator use per ventilated patient, 13% of total ventilator demand will occur at peak, and a 33.7% weighted average mortality risk while on a ventilator. At peak, for a 20% CAR, low severity scenario, an additional 7000 to 11 000 ventilators will be needed, averting a pandemic total of 35 000 to 55 000 deaths. A 30% CAR, high severity scenario, will need approximately 35 000 to 60 500 additional ventilators, averting a pandemic total 178 000 to 308 000 deaths. Estimates of deaths averted may not be realized because successful ventilation also depends on sufficient numbers of suitably trained staff, needed supplies (eg, drugs, reliable oxygen sources, suction apparatus, circuits, and monitoring equipment) and timely ability to match access to ventilators with critically ill cases. There is a clear challenge to plan and prepare to meet demands for mechanical ventilators for a future severe pandemic.
Url:
DOI: 10.1093/cid/civ089
PubMed: 25878301
PubMed Central: 4603361
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PMC:4603361Le document en format XML
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<term>Modèles théoriques</term>
<term>Pandémies</term>
<term>Planification des mesures d'urgence en cas de catastrophe ()</term>
<term>Respirateurs artificiels (ressources et distribution)</term>
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<term>Sous-type H7N9 du virus de la grippe A (pathogénicité)</term>
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<front><div type="abstract" xml:lang="en"><title>Abstract</title>
<p>An outbreak in China in April 2013 of human illnesses due to avian influenza A(H7N9)
virus provided reason for US public health officials to revisit existing national pandemic
response plans. We built a spreadsheet model to examine the potential demand for invasive
mechanical ventilation (excluding “rescue therapy” ventilation). We considered scenarios
of either 20% or 30% gross influenza clinical attack rate (CAR), with a “low severity”
scenario with case fatality rates (CFR) of 0.05%–0.1%, or a “high severity” scenario (CFR:
0.25%–0.5%). We used rates-of-influenza-related illness to calculate the numbers of
potential clinical cases, hospitalizations, admissions to intensive care units, and need
for mechanical ventilation. We assumed 10 days ventilator use per ventilated patient, 13%
of total ventilator demand will occur at peak, and a 33.7% weighted average mortality risk
while on a ventilator. At peak, for a 20% CAR, low severity scenario, an additional 7000
to 11 000 ventilators will be needed, averting a pandemic total of 35 000 to 55 000
deaths. A 30% CAR, high severity scenario, will need approximately 35 000 to 60 500
additional ventilators, averting a pandemic total 178 000 to 308 000 deaths. Estimates of
deaths averted may not be realized because successful ventilation also depends on
sufficient numbers of suitably trained staff, needed supplies (eg, drugs, reliable oxygen
sources, suction apparatus, circuits, and monitoring equipment) and timely ability to
match access to ventilators with critically ill cases. There is a clear challenge to plan
and prepare to meet demands for mechanical ventilators for a future severe pandemic.</p>
</div>
</front>
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<wicri:noCountry code="subfield">Contracted to the Office of the Assistant Secretary for Preparedness and Response</wicri:noCountry>
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<author><name sortKey="Nystrom, Scott V" sort="Nystrom, Scott V" uniqKey="Nystrom S" first="Scott V." last="Nystrom">Scott V. Nystrom</name>
<affiliation><nlm:aff id="af4"><addr-line>Division of Medical Countermeasure Strategy and Requirements, Office of the Assistant Secretary for Preparedness and Response, US Department of Health and Human Services, Washington, D.C.</addr-line>
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<wicri:noCountry code="subfield">D.C.</wicri:noCountry>
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<wicri:noCountry code="subfield">D.C.</wicri:noCountry>
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<front><div type="abstract" xml:lang="en"><title>Abstract</title>
<p>An outbreak in China in April 2013 of human illnesses due to avian influenza A(H7N9)
virus provided reason for US public health officials to revisit existing national pandemic
response plans. We built a spreadsheet model to examine the potential demand for invasive
mechanical ventilation (excluding “rescue therapy” ventilation). We considered scenarios
of either 20% or 30% gross influenza clinical attack rate (CAR), with a “low severity”
scenario with case fatality rates (CFR) of 0.05%–0.1%, or a “high severity” scenario (CFR:
0.25%–0.5%). We used rates-of-influenza-related illness to calculate the numbers of
potential clinical cases, hospitalizations, admissions to intensive care units, and need
for mechanical ventilation. We assumed 10 days ventilator use per ventilated patient, 13%
of total ventilator demand will occur at peak, and a 33.7% weighted average mortality risk
while on a ventilator. At peak, for a 20% CAR, low severity scenario, an additional 7000
to 11 000 ventilators will be needed, averting a pandemic total of 35 000 to 55 000
deaths. A 30% CAR, high severity scenario, will need approximately 35 000 to 60 500
additional ventilators, averting a pandemic total 178 000 to 308 000 deaths. Estimates of
deaths averted may not be realized because successful ventilation also depends on
sufficient numbers of suitably trained staff, needed supplies (eg, drugs, reliable oxygen
sources, suction apparatus, circuits, and monitoring equipment) and timely ability to
match access to ventilators with critically ill cases. There is a clear challenge to plan
and prepare to meet demands for mechanical ventilators for a future severe pandemic.</p>
</div>
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<pubmed><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Estimates of the demand for mechanical ventilation in the United States during an influenza pandemic.</title>
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<affiliation wicri:level="1"><nlm:affiliation>Division of Strategic National Stockpile, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia.</nlm:affiliation>
<country xml:lang="fr">Géorgie (pays)</country>
<wicri:regionArea>Division of Strategic National Stockpile, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta</wicri:regionArea>
<wicri:noRegion>Atlanta</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Ajao, Adebola" sort="Ajao, Adebola" uniqKey="Ajao A" first="Adebola" last="Ajao">Adebola Ajao</name>
<affiliation><nlm:affiliation>Formerly, GAP Solutions Incorporated, Contracted to the Office of the Assistant Secretary for Preparedness and Response.</nlm:affiliation>
<wicri:noCountry code="subField">Contracted to the Office of the Assistant Secretary for Preparedness and Response</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Nystrom, Scott V" sort="Nystrom, Scott V" uniqKey="Nystrom S" first="Scott V" last="Nystrom">Scott V. Nystrom</name>
<affiliation><nlm:affiliation>Division of Medical Countermeasure Strategy and Requirements, Office of the Assistant Secretary for Preparedness and Response, US Department of Health and Human Services, Washington, D.C.</nlm:affiliation>
<wicri:noCountry code="subField">D.C.</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Koonin, Lisa M" sort="Koonin, Lisa M" uniqKey="Koonin L" first="Lisa M" last="Koonin">Lisa M. Koonin</name>
<affiliation wicri:level="1"><nlm:affiliation>Influenza Coordination Unit, Office of Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.</nlm:affiliation>
<country xml:lang="fr">Géorgie (pays)</country>
<wicri:regionArea>Influenza Coordination Unit, Office of Infectious Diseases, Centers for Disease Control and Prevention, Atlanta</wicri:regionArea>
<wicri:noRegion>Atlanta</wicri:noRegion>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PubMed</idno>
<date when="2015">2015</date>
<idno type="RBID">pubmed:25878301</idno>
<idno type="pmid">25878301</idno>
<idno type="doi">10.1093/cid/civ089</idno>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Estimates of the demand for mechanical ventilation in the United States during an influenza pandemic.</title>
<author><name sortKey="Meltzer, Martin I" sort="Meltzer, Martin I" uniqKey="Meltzer M" first="Martin I" last="Meltzer">Martin I. Meltzer</name>
<affiliation><nlm:affiliation>Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases.</nlm:affiliation>
<wicri:noCountry code="subField">National Center for Emerging and Zoonotic Infectious Diseases</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Patel, Anita" sort="Patel, Anita" uniqKey="Patel A" first="Anita" last="Patel">Anita Patel</name>
<affiliation wicri:level="1"><nlm:affiliation>Division of Strategic National Stockpile, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia.</nlm:affiliation>
<country xml:lang="fr">Géorgie (pays)</country>
<wicri:regionArea>Division of Strategic National Stockpile, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta</wicri:regionArea>
<wicri:noRegion>Atlanta</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Ajao, Adebola" sort="Ajao, Adebola" uniqKey="Ajao A" first="Adebola" last="Ajao">Adebola Ajao</name>
<affiliation><nlm:affiliation>Formerly, GAP Solutions Incorporated, Contracted to the Office of the Assistant Secretary for Preparedness and Response.</nlm:affiliation>
<wicri:noCountry code="subField">Contracted to the Office of the Assistant Secretary for Preparedness and Response</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Nystrom, Scott V" sort="Nystrom, Scott V" uniqKey="Nystrom S" first="Scott V" last="Nystrom">Scott V. Nystrom</name>
<affiliation><nlm:affiliation>Division of Medical Countermeasure Strategy and Requirements, Office of the Assistant Secretary for Preparedness and Response, US Department of Health and Human Services, Washington, D.C.</nlm:affiliation>
<wicri:noCountry code="subField">D.C.</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Koonin, Lisa M" sort="Koonin, Lisa M" uniqKey="Koonin L" first="Lisa M" last="Koonin">Lisa M. Koonin</name>
<affiliation wicri:level="1"><nlm:affiliation>Influenza Coordination Unit, Office of Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.</nlm:affiliation>
<country xml:lang="fr">Géorgie (pays)</country>
<wicri:regionArea>Influenza Coordination Unit, Office of Infectious Diseases, Centers for Disease Control and Prevention, Atlanta</wicri:regionArea>
<wicri:noRegion>Atlanta</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series><title level="j">Clinical infectious diseases : an official publication of the Infectious Diseases Society of America</title>
<idno type="eISSN">1537-6591</idno>
<imprint><date when="2015" type="published">2015</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Disaster Planning (methods)</term>
<term>Humans</term>
<term>Influenza A Virus, H7N9 Subtype (pathogenicity)</term>
<term>Influenza, Human (epidemiology)</term>
<term>Influenza, Human (mortality)</term>
<term>Influenza, Human (therapy)</term>
<term>Intensive Care Units (supply & distribution)</term>
<term>Models, Theoretical</term>
<term>Pandemics</term>
<term>Public Health (methods)</term>
<term>Respiration, Artificial (instrumentation)</term>
<term>United States (epidemiology)</term>
<term>Ventilators, Mechanical (supply & distribution)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Grippe humaine ()</term>
<term>Grippe humaine (mortalité)</term>
<term>Grippe humaine (épidémiologie)</term>
<term>Humains</term>
<term>Modèles théoriques</term>
<term>Pandémies</term>
<term>Planification des mesures d'urgence en cas de catastrophe ()</term>
<term>Respirateurs artificiels (ressources et distribution)</term>
<term>Santé publique ()</term>
<term>Sous-type H7N9 du virus de la grippe A (pathogénicité)</term>
<term>Unités de soins intensifs (ressources et distribution)</term>
<term>Ventilation artificielle (instrumentation)</term>
<term>États-Unis d'Amérique (épidémiologie)</term>
</keywords>
<keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>United States</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Influenza, Human</term>
</keywords>
<keywords scheme="MESH" qualifier="instrumentation" xml:lang="en"><term>Respiration, Artificial</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Disaster Planning</term>
<term>Public Health</term>
</keywords>
<keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Influenza, Human</term>
</keywords>
<keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Grippe humaine</term>
</keywords>
<keywords scheme="MESH" qualifier="pathogenicity" xml:lang="en"><term>Influenza A Virus, H7N9 Subtype</term>
</keywords>
<keywords scheme="MESH" qualifier="pathogénicité" xml:lang="fr"><term>Sous-type H7N9 du virus de la grippe A</term>
</keywords>
<keywords scheme="MESH" qualifier="ressources et distribution" xml:lang="fr"><term>Respirateurs artificiels</term>
<term>Unités de soins intensifs</term>
</keywords>
<keywords scheme="MESH" qualifier="supply & distribution" xml:lang="en"><term>Intensive Care Units</term>
<term>Ventilators, Mechanical</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Influenza, Human</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Grippe humaine</term>
<term>Ventilation artificielle</term>
<term>États-Unis d'Amérique</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Humans</term>
<term>Models, Theoretical</term>
<term>Pandemics</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Grippe humaine</term>
<term>Humains</term>
<term>Modèles théoriques</term>
<term>Pandémies</term>
<term>Planification des mesures d'urgence en cas de catastrophe</term>
<term>Santé publique</term>
</keywords>
<keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>États-Unis</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">An outbreak in China in April 2013 of human illnesses due to avian influenza A(H7N9) virus provided reason for US public health officials to revisit existing national pandemic response plans. We built a spreadsheet model to examine the potential demand for invasive mechanical ventilation (excluding "rescue therapy" ventilation). We considered scenarios of either 20% or 30% gross influenza clinical attack rate (CAR), with a "low severity" scenario with case fatality rates (CFR) of 0.05%-0.1%, or a "high severity" scenario (CFR: 0.25%-0.5%). We used rates-of-influenza-related illness to calculate the numbers of potential clinical cases, hospitalizations, admissions to intensive care units, and need for mechanical ventilation. We assumed 10 days ventilator use per ventilated patient, 13% of total ventilator demand will occur at peak, and a 33.7% weighted average mortality risk while on a ventilator. At peak, for a 20% CAR, low severity scenario, an additional 7000 to 11,000 ventilators will be needed, averting a pandemic total of 35,000 to 55,000 deaths. A 30% CAR, high severity scenario, will need approximately 35,000 to 60,500 additional ventilators, averting a pandemic total 178,000 to 308,000 deaths. Estimates of deaths averted may not be realized because successful ventilation also depends on sufficient numbers of suitably trained staff, needed supplies (eg, drugs, reliable oxygen sources, suction apparatus, circuits, and monitoring equipment) and timely ability to match access to ventilators with critically ill cases. There is a clear challenge to plan and prepare to meet demands for mechanical ventilators for a future severe pandemic.</div>
</front>
</TEI>
</pubmed>
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