tetano
Editor, Senior Moderator
Harefuah. 2017 Sep;156(9):559-563.
[h=1][THE MORBIDITY AND MORTALITY OF INFLUENZA PATIENTS TREATED AT RAMBAM MEDICAL CENTER INTENSIVE CARE UNIT IN THE YEARS 2009-2014].[/h] [Article in Hebrew]
Bar-Lavie Y[SUP]1[/SUP], Hussein K[SUP]2[/SUP], Mayo A[SUP]1[/SUP], King D[SUP]1[/SUP], Kra-Oz Z[SUP]3[/SUP], Paul M[SUP]2[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]INTRODUCTION:[/h] Data regarding the characteristics and results of the treatment of patients hospitalized in intensive care units (ICUs) with influenza in Israel are limited.
[h=4]AIMS:[/h] We evaluated the characteristics and outcomes of patients treated at Rambam Medical Center at the adult department of critical care medicine for influenza between the years 2009-2014.
[h=4]METHODS:[/h] A retrospective cohort study was conducted. Patients were detected by laboratory reports and data were extracted from electronic medical records.
[h=4]RESULTS:[/h] The study included 64 patients with laboratory-proven influenza. Median age was 54 years (range 17-83) and symptom duration before admission was 5 days (1-14). The median APACHE-II score at admission was 31.5 and 63.5% were in hemodynamic shock mandating the use of vasopressors. All patients received mechanical ventilation. Inhalation of nitric oxide was needed in a third; 14.3% needed Intra-Pulmonary Percussive Ventilation and steroids were given to 57.1%. ICU mortality was 24/64 (37.5%). Factors significantly associated with mortality were older age, longer length of disease prior to ICU admission, APACHE-II score, septic shock and creatinine. Mortality during the last season was lower than observed during the 2009 pandemia despite increasing severity of illness.
[h=4]CONCLUSIONS:[/h] The appearance of a new strain of influenza leads to high morbidity, complications and mortality due to low population immunity. There are no randomized controlled trials evaluating the efficacy of anti-viral drugs and other treatments in severe Influenza with complications.
[h=4]DISCUSSION:[/h] The treatment of critically-ill patients with severe influenza is complex, mandates advanced techniques of mechanical ventilation and hemodynamic support. Under intense supportive care most patients with influenza survive.
PMID: 28971652
[h=1][THE MORBIDITY AND MORTALITY OF INFLUENZA PATIENTS TREATED AT RAMBAM MEDICAL CENTER INTENSIVE CARE UNIT IN THE YEARS 2009-2014].[/h] [Article in Hebrew]
Bar-Lavie Y[SUP]1[/SUP], Hussein K[SUP]2[/SUP], Mayo A[SUP]1[/SUP], King D[SUP]1[/SUP], Kra-Oz Z[SUP]3[/SUP], Paul M[SUP]2[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]INTRODUCTION:[/h] Data regarding the characteristics and results of the treatment of patients hospitalized in intensive care units (ICUs) with influenza in Israel are limited.
[h=4]AIMS:[/h] We evaluated the characteristics and outcomes of patients treated at Rambam Medical Center at the adult department of critical care medicine for influenza between the years 2009-2014.
[h=4]METHODS:[/h] A retrospective cohort study was conducted. Patients were detected by laboratory reports and data were extracted from electronic medical records.
[h=4]RESULTS:[/h] The study included 64 patients with laboratory-proven influenza. Median age was 54 years (range 17-83) and symptom duration before admission was 5 days (1-14). The median APACHE-II score at admission was 31.5 and 63.5% were in hemodynamic shock mandating the use of vasopressors. All patients received mechanical ventilation. Inhalation of nitric oxide was needed in a third; 14.3% needed Intra-Pulmonary Percussive Ventilation and steroids were given to 57.1%. ICU mortality was 24/64 (37.5%). Factors significantly associated with mortality were older age, longer length of disease prior to ICU admission, APACHE-II score, septic shock and creatinine. Mortality during the last season was lower than observed during the 2009 pandemia despite increasing severity of illness.
[h=4]CONCLUSIONS:[/h] The appearance of a new strain of influenza leads to high morbidity, complications and mortality due to low population immunity. There are no randomized controlled trials evaluating the efficacy of anti-viral drugs and other treatments in severe Influenza with complications.
[h=4]DISCUSSION:[/h] The treatment of critically-ill patients with severe influenza is complex, mandates advanced techniques of mechanical ventilation and hemodynamic support. Under intense supportive care most patients with influenza survive.
PMID: 28971652