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Management of acute respiratory complications from influenza A (H1N1) infection: experience of a tertiary-level Intensive Care Unit

tetano

Editor, Senior Moderator
Minerva Anestesiol. 2011 Apr 14. [Epub ahead of print]
Management of acute respiratory complications from influenza A (H1N1) infection: experience of a tertiary-level Intensive Care Unit.

Grasselli G, Bombino M, Patroniti N, Foti G, Benini A, Abbruzzese C, Fumagalli R, Pesenti A.

Department of Perioperative Medicine and Intensive Care, San Gerardo Hospital, Monza, Italy - jaku71@gmail.com.
Abstract

BACKGROUND: The novel influenza A (H1N1) pandemic was associated with an epidemic of critical illness.

METHODS: We describe the clinical profiles of critically ill patients with severe complications due to microbiologically confirmed pandemic influenza A (H1N1) infection admitted to a medical ICU in Monza, Italy, over a 6-month period.

RESULTS: From August 2009 to January 2010, 19 patients (13 adults and 6 children) required ICU admission. Nine subjects were referred to our hospital from other ICUs. In all patients, with the exception of a case of severe septic shock, the cause of ICU admission was acute respiratory failure. Other nonpulmonary organ failures were common. A trial of non-invasive ventilation was attempted in 13 cases and was successful in four of them. The majority of the patients required invasive mechanical ventilation. In the 7 most severely hypoxemic patients, we applied veno-venous ECLS, with a very high rate of success. The median ICU stay was 9 days (range 1-78 days). Sixteen out of 19 (84%) patients survived.

CONCLUSION: In the majority of our patients, critical illness caused by pandemic influenza A (H1N1) was associated with severe hypoxemia, multiple organ failure, requirement for mechanical ventilation and frequent use of rescue therapies and ECLS support.

PMID: 21494211 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/21494211
 
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