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Med Intensiva. 2011 May;35(4):208-16. doi: 10.1016/j.medin.2011.03.001. Epub 2011 Apr 14.

First influenza season after the 2009 pandemic influenza: report of the first 300 ICU admissions in Spain.

Collaborators (264)

Cobo P, Martins J, Carbayo C, Robles-Musso E, Cárdenas A, Fierro J, Fernández DO, Sierra R, Huertos MJ, Pozo JC, Guerrero R, Márquez E, Rodríguez-Carvajal M, Estella Á, Pomares J, Ballesteros JL, Fernández Y, Lobato F, Prieto JF, Albofedo-Sánchez J, Martínez P, María Victoria de LT, Nieto M, Díaz Castellanos MÁ, Sevilla G, Garnacho-Montero J, Hinojosa R, Fernández E, Loza A, León C, Arenzana Á, Ocaña D, Navarrete I, Zaheri Beryanaki M, Sánchez I, Avellanas ML, Lander A, Ramírez de Arellano SG, Marquina Lacueva MI, Luque P, Plumed Serrano E, Martín Lázaro JF, González I, Montón JM, Dorado Regil P, Iglesias L, Pascual González C, Quiroga, García-Rodríguez Á, Socias L, Ibánez P, Borges-Sa M, Socias A, Del Castillo A, Jordà Marcos R, Bonell JM, Amestarán I, Ruiz-Santana S, José Díaz J, Sisón, Hernández D, Trujillo A, Regalado L, Lorente L, Martín M, Martínez S, Cáceres JJ, Suberviola B, Ugarte P, García-López F, Álvaro Alonso Á, Pasilla A, Gómez Grande ML, Albaya A, Canabal A, Marina L, Simón A, Añón JM, López Messa JB, López Pueyo MJ, Ortiz MV, Ferreras Z, Macias S, Berezo JÁ, Blanco Varela J, Andaluz Ojeda A, Álvarez Terrero A, Tena Ezpeleta F, Páez Z, García Á, Catalán RM, Ferrer M, Torres A, Cilloniz C, Barbadillo S, Cabré L, Baeza I, Rovira A, Álvarez-Lerma F, Vázquez A, Nolla J, Fernández F, Ramón Cervelló J, Iglesia R, Mañez R, Ballús J, Granada RM, Vallés J, Ortiz M, Guía C, Arméstar F, Páez J, Almirall J, Balanzo X, Rello J, Arnau E, Pérez M, Laborda C, Souto J, Palomar M, Catalán I, Sirvent JM, Ferri C, López de Arbina C, Badía M, Valverdú-Vidal M, Barcenilla F, Magret M, Esteban MF, Luna J, Nava JM, González de Molina J, Josic Z, Gurri F, Rodríguez P, Rodríguez A, Lisboa T, Pobo Á, Pobo Á, Díaz RM, Mesalles E, de Mendoza D, Juliá-Narváez J, Fernández-Zapata A, Recio T, Arrascaeta A, García-Ramos MJ, Gallego E, Bueno F, Díaz M, Cordero ML, Pastor JA, Álvarez-Rocha L, Vila D, Díaz Lamas A, Blanco Pérez J, Ortiz Piquer M, Merayo E, López-Ciudad VJ, Cortes Cañones J, Vilaboy E, Villar Chao J, Saborido EM, González RJ, Freita S, Alemparte E, Ortega A, López AM, Canabal J, Ferres E, Monzón JL, Goñi F, Del Nogal Sáez F, Blasco Navalpotro M, García-Torrejón MC, Pérez-Calvo C, López D, Arnaiz L, Sánchez-Alonso S, Velayos C, del Río F, González MÁ, Cruz Martín M, Molina JM, Montejo JC, Catalán M, Albert P, de Pablo A, Guerrero JE, Zurita M, Benitez Peyrat J, Cerdá E, Alvarez M, Pey C, Rodríguez M, Palencia E, Caballero R, Vaquero C, Mariscal F, García S, Carrasco N, Prieto I, Liétor A, Ramos R, Galván B, Figueira JC, Soriano MC, Galdós P, Balandin Moreno B, del Cabo F, Hermosa C, Gordo F, Algora A, Paredes A, Cambronero JA, Gómez-Rosado S, Prado López LM, Esteban A, Lorente JA, Nin N, Martínez S, Felices Abad F, Martínez M, Manuel Butí S, Gil Rueda B, García F, Macaya L, Maraví-Poma E, Jimenez Urra I, Macaya Redin L, Tellería A, Insansti J, González N, Marco P, Vidaur L, Santamaría B, Rodríguez T, Vergara JC, Iruretagoyena Amiano JR, Manzano A, Castillo Arenal C, Olaechea PM, Martín H, Blanquer J, Reig Valero R, Belenger A, Altaba S, Álvarez-Sánchez B, Alberto Picos S, Sánchez-Miralles Á, Bonastre J, Palamo M, Cebrian J, Cuñat J, Romero B, Zaragoza R, Tormo C, Paricio V, Marques A, Sánchez-Morcillo S, Tormo S, Latour J, Ángel García M, Ribas A.

Author information

1
Hospital Joan XXIII, Critical Care Department, IISPV, URV, CIBER Enfermedades Respiratorias, Tarragona, Spain. ahr1161@yahoo.es

Abstract

INTRODUCTION:

During the 2009 influenza pandemic, several reports were published, nevertheless, data on the clinical profiles of critically ill patients with the new virus infection during this second outbreak are still lacking.

MATERIAL METHODS:

Prospective, observational, multi-center study conducted in 148 Spanish intensive care units (ICU) during epidemiological weeks 50-52 of 2010 and weeks 1 - 4 of 2011.

RESULTS:

Three hundred patients admitted to an intensive care unit (ICU) with confirmed An/H1N1 infection were analyzed. The median age was 49 years [IQR=38-58] and 62% were male. The mean APACHE II score was 16.9 ± 7.5 and the mean SOFA score was 6.3 ± 3.5 on admission. Comorbidities were present in 76% (n=228) of cases and 111 (37.4%) patients were reportedly obese and 59 (20%) were COPD. The main presentation was viral pneumonia with severe hypoxemia in 65.7% (n=197) of the patients whereas co-infection was identified in 54 (18%) patients. All patients received antiviral treatment and initiated empirically in 194 patients (65.3%), however only 53 patients (17.6%) received early antiviral treatment. Vaccination was only administered in 22 (7.3%) patients. Sixty-seven of 200 patients with ICU discharge died. Haematological disease, severity of illness, infiltrates in chest X-ray and need for mechanical ventilation were variables independently associated with ICU mortality.

CONCLUSIONS:

In patients admitted to the ICU in the post-pandemic seasonal influenza outbreak vaccination was poorly implemented and appear to have higher frequency of severe comorbidities, severity of illness, incidence of primary viral pneumonia and increased mortality when compared with those observed in the 2009 pandemic outbreak.

PMID:
21496964
DOI:
10.1016/j.medin.2011.03.001
[Indexed for MEDLINE]
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