Critically Ill Patients With 2009 Influenza A(H1N1) Infection in Canada

Kumar, Anand; Zarychanski, Ryan; Pinto, Ruxandra; Cook, Deborah J.; Marshall, John C.; Lacroix, Jacques; Stelfox, Henry T.; Bagshaw, Sean M.; Choong, Karen; Lamontagne, François; Turgeon, Alexis F.; Lapinsky, Stephen E.; Ahern, Stéphane P.; Smith, Orla; Siddiqui, Faisal; Jouvet, Philippe; Khwaja, Kosar; McIntyre, Lauralyn; Menon, Kusum; Hutchison, Jamie; Hornstein, David; Joffe, Ari R.; Lauzier, François; Singh, Jeffrey M.; Karachi, Tim; Wiebe, Kim; Olafson, Kendiss; Ramsey, Clare D.; Sharma, Sat; Dodek, Peter; Meade, Maureen O.; Hall, Richard; Fowler, Robert

doi:10.1001/jama.2009.1496

Cited by 1,236 publications

(1,380 citation statements)

References 26 publications

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“…A majority of hospitalized patients requiring therapy in ICUs were adults <65 years who on admission had respiratory failure due mainly to primary influenza pneumonia in agreement with other observations,8, 15, 21, 22, 23, 24 and in clear contrast to seasonal influenza. The number of patients that are admitted to an ICU may vary related to criteria used by the institution.…”

Section: Discussionsupporting

confidence: 90%

“…The number of patients that are admitted to an ICU may vary related to criteria used by the institution. Consequently, the mortality in ICU differs has been reported from 11% to 25% 15, 21, 22, 23, 24, 25. Many patients with severe disease have co‐morbidities, but it is well described that fatalities from pandemic influenza may occur in previously healthy subjects.…”

Section: Discussionmentioning

confidence: 99%

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The first, second and third wave of pandemic influenza A (H1N1)pdm09 in North Denmark Region 2009–2011: a population‐based study of hospitalizations

Ørsted

Mølvadgaard

Nielsen

et al. 2013

Influenza Resp Viruses

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Background and objectivesDenmark experienced three waves of the new pandemic influenza A (H1N1)pdm09 from July 2009 to February 2011. The aim of the study was to describe the epidemiology and clinical characteristics of hospitalized patients in a defined population of North Denmark Region with a mixed urban and rural community of 579 000 inhabitants.MethodsReview of medical records of all hospitalized patients with confirmed influenza A from July 2009 to February 2011.ResultsTwo hundred and seventy‐three patients were admitted to hospital. The age‐related population incidences of hospitalization were as follows: 0–14 years: 111/100 000, 15–64 years: 39/100 000, and ≥65 years: 17/100 000. During the first wave (July 2009–August 2009), three patients were admitted – none received treatment in intensive care units (ICUs), during the second wave (October 2009–January 2010), 158 patients were admitted – nine received treatment in ICUs, and during the third wave (December 2010–February 2011), 112 patients were admitted – 25 received treatment in ICUs. Fourteen patients (5%) died within 30 days of diagnosis (median 55 years; range 14–76 years) and additional seven patients (2·6%) died within 365 days (median 25 years; range 1–86 years).ConclusionsPatients hospitalized with pandemic influenza A (H1N1)pdm09 were predominantly children and younger adults, and only a few patients were >65 years. The third wave was the most severe taking the number and percentage of patients admitted to ICUs and 30‐day mortality into consideration. We observed that the incidence of hospitalizations as well as clinical severity among younger adults did not decline from the second to the third wave.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

The first, second and third wave of pandemic influenza A (H1N1)pdm09 in North Denmark Region 2009–2011: a population‐based study of hospitalizations

Ørsted

Mølvadgaard

Nielsen

et al. 2013

Influenza Resp Viruses

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“…Bacterial coinfection rates ranging from 20% to 33% were reported in patients with severe influenza 35 , 38 , 39 . Bacterial coinfections were found to be 15·8% in the 19 patients with lung involvement in this series; chances of under‐diagnosis of bacterial coinfection in these patients were high, as aggressive diagnostic work‐up for bacterial infections was carried out in only some of them (Table 3).…”

Section: Discussionmentioning

confidence: 68%

2009 pandemic Influenza A (H1N1): clinical and laboratory characteristics in pediatric and adult patients and in patients with pulmonary involvement

Lee

Liu

Wang

et al. 2012

Influenza Resp Viruses

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Please cite this paper as: Lee and Liu et al. (2012) 2009 pandemic Influenza A (H1N1): clinical and laboratory characteristics in pediatric and adult patients and in patients with pulmonary involvement. Influenza and Other Respiratory Viruses 6(601), e152–e161. Background To better understand clinical and laboratory characteristics in children, adults, and patients with lung involvement suffering 2009 pandemic influenza A (H1N1). Methods A total of 442 patients with 2009 pandemic influenza A (H1N1) were retrospectively analyzed. Results Comparing to their adult counterpart (n = 55), pediatric patients (n = 387) had significantly higher frequencies of fever, rhinorrhea, cough, sore throat, nausea/vomiting, and longer length of fever; lower frequencies of chest pain and dyspnea; higher incidence of lymphopenia; and lower incidence of elevated serum C‐reactive protein. Among the 227 patients with radiographs available, lung involvement was found in 19 (8·4%) (52·6% consolidation and 47·4% interstitial infiltrations), including 18 children and one adult. One child with lung consolidation died of multiorgan failure. Significant findings in patients with lung involvement included predominant young age (≤10 years), prolonged fever, and delayed oseltamivir therapy (≥48 hours after onset of illness); higher frequencies of dyspnea, nausea/vomiting, and altered consciousness; and higher incidences of leukopenia, elevated serum creative kinase, and lactic dehydrogenase. Conclusions Among patients with 2009 pandemic influenza A (H1N1), we found significant difference in clinical manifestations between children and adults, and significant differences in clinical and laboratory manifestations between patients with lung involvement and those without. On the basis of data from this study and the existing literature, early treatment with oseltamivir is recommended for patients with 2009 pandemic influenza A (H1N1), regardless of age.

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“…3,7,8 Such patients present with moderate to severe acute respiratory distress syndrome (ARDS) associated with high morbidity and mortality rates (15-40%). 3,9,10 These pulmonary and remote alterations present many similarities to ''bacterial'' sepsis, even though they may occur in the absence of bacterial infection. The H1N1 infection is associated with a strong pulmonary inflammatory response with increased production of interleukin (IL)-10, IL-4, and interferon-gamma (IFN-c).…”

Section: Résumémentioning

confidence: 99%

Microcirculatory abnormalities in patients with severe influenza A (H1N1) infection

Salgado

Ortiz

Favory

et al. 2010

Can J Anesth/J Can Anesth

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Purpose This study was designed to evaluate the degree of microcirculatory abnormalities in patients with severe influenza A (H1N1) infection. Methods We assessed the sublingual microcirculation in seven consecutive patients with acute lung injury related to influenza A (H1N1) infection. The evaluation was carried out using sidestream dark field (SDF) imaging within the first 96 hr after the patients were admitted to the intensive care unit. Thenar oxygen saturation (StO 2 ) was also measured with near-infrared spectroscopy (NIRS) during a vascular occlusion test. In addition, the Lung Injury Score (LIS) and the APACHE II and SOFA scores were recorded. Results All patients received invasive mechanical ventilation and at least one of the following adjuvant therapies: inhaled nitric oxide (n = 4), extracorporeal membrane oxygenation (n = 1), prone position (n = 4), recruitment maneuver (n = 3), and hydrocortisone 50 mgÁhr -6

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Critically Ill Patients With 2009 Influenza A(H1N1) Infection in Canada

Cited by 1,236 publications

References 26 publications

The first, second and third wave of pandemic influenza A (H1N1)pdm09 in North Denmark Region 2009–2011: a population‐based study of hospitalizations

The first, second and third wave of pandemic influenza A (H1N1)pdm09 in North Denmark Region 2009–2011: a population‐based study of hospitalizations

2009 pandemic Influenza A (H1N1): clinical and laboratory characteristics in pediatric and adult patients and in patients with pulmonary involvement

Microcirculatory abnormalities in patients with severe influenza A (H1N1) infection

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