tetano
Editor, Senior Moderator
Chest. 2012 Feb 23. [Epub ahead of print]
Long-term outcomes of pandemic 2009 influenza A (H1N1)-associated severe acute respiratory distress syndrome.
Luyt CE, Combes A, Becquemin MH, Beigelman-Aubry C, Hatem S, Brun AL, Zraik N, Carrat F, Grenier PA, Richard JC, Mercat A, Brochard L, Brun-Buisson C, Chastre J; for the REVA Study Group.
Source
1Service de R?animation M?dicale.
Abstract
ABSTRACT
BACKGROUND:
No data on long-term outcomes of survivors of 2009 influenza A (H1N1) (2009-H1N1)-associated ARDS are available. To compare the 1-year outcomes of survivors of 2009-H1N1-associated acute respiratory distress syndrome (ARDS), according to extracorporeal lung assist (ECLA) use or not, using its need as an ARDS-severity surrogate.
METHODS:
ARDS survivors (12 with ECLA vs. 25 without, corresponding to 75% and 54% of the eligible patients for each group, respectively), selected from the French registry of critically ill, 2009-H1N1-infected patients, had previously been healthy with only pregnancy and/or moderate obesity (BMI≤35 kg/m(2)) as known risk factors for 2009-H1N1 infection. Lung function and morphology, health-related quality of life (HRQoL) and psychological impairment were evaluated.
RESULTS:
At 1-year post-ICU discharge, for ECLA and no-ECLA groups, respectively, 50% and 40% reported significant exertion dyspnea, 83% and 64% had returned to work, 75% and 64% had decreased diffusion capacity across the blood-gas barrier, despite their near-normal and similar lung-function-test results. For both groups, exercise-test results showed diminished but comparable exercise capacities, with similar alveolar-arterial O(2) gradients at peak exercise, and CT-scan showed minor abnormal findings. SF-36-assessed HRQoL was poorer for both groups than a sex- and age-matched general population, but without between-group differences. ECLA and no-ECLA patients, respectively, had symptoms of anxiety (50% and 56%) and depression (28% and 28%), and were at risk for post-traumatic stress disorder (41% and 44%).
CONCLUSIONS:
One-year post-ICU discharge, a majority of 2009-H1N1-associated ARDS survivors had minor lung disabilities with diminished diffusion capacities across the blood-gas barrier, and most had psychological impairment and poorer HRQoL than sex- and age-matched general population. ECLA and no-ECLA patients had comparable outcomes.
PMID:
22362874
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/22362874
Long-term outcomes of pandemic 2009 influenza A (H1N1)-associated severe acute respiratory distress syndrome.
Luyt CE, Combes A, Becquemin MH, Beigelman-Aubry C, Hatem S, Brun AL, Zraik N, Carrat F, Grenier PA, Richard JC, Mercat A, Brochard L, Brun-Buisson C, Chastre J; for the REVA Study Group.
Source
1Service de R?animation M?dicale.
Abstract
ABSTRACT
BACKGROUND:
No data on long-term outcomes of survivors of 2009 influenza A (H1N1) (2009-H1N1)-associated ARDS are available. To compare the 1-year outcomes of survivors of 2009-H1N1-associated acute respiratory distress syndrome (ARDS), according to extracorporeal lung assist (ECLA) use or not, using its need as an ARDS-severity surrogate.
METHODS:
ARDS survivors (12 with ECLA vs. 25 without, corresponding to 75% and 54% of the eligible patients for each group, respectively), selected from the French registry of critically ill, 2009-H1N1-infected patients, had previously been healthy with only pregnancy and/or moderate obesity (BMI≤35 kg/m(2)) as known risk factors for 2009-H1N1 infection. Lung function and morphology, health-related quality of life (HRQoL) and psychological impairment were evaluated.
RESULTS:
At 1-year post-ICU discharge, for ECLA and no-ECLA groups, respectively, 50% and 40% reported significant exertion dyspnea, 83% and 64% had returned to work, 75% and 64% had decreased diffusion capacity across the blood-gas barrier, despite their near-normal and similar lung-function-test results. For both groups, exercise-test results showed diminished but comparable exercise capacities, with similar alveolar-arterial O(2) gradients at peak exercise, and CT-scan showed minor abnormal findings. SF-36-assessed HRQoL was poorer for both groups than a sex- and age-matched general population, but without between-group differences. ECLA and no-ECLA patients, respectively, had symptoms of anxiety (50% and 56%) and depression (28% and 28%), and were at risk for post-traumatic stress disorder (41% and 44%).
CONCLUSIONS:
One-year post-ICU discharge, a majority of 2009-H1N1-associated ARDS survivors had minor lung disabilities with diminished diffusion capacities across the blood-gas barrier, and most had psychological impairment and poorer HRQoL than sex- and age-matched general population. ECLA and no-ECLA patients had comparable outcomes.
PMID:
22362874
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/22362874