Pandemic 2009 Influenza A in Argentina

Bakker, Jan; Ríos, Fernando; Apezteguía, Carlos; Reina, Rosa; Neira, Jorge; Ceraso, Daniel; Orlandi, Cristina; Valentini, Ricardo; Tiribelli, Norberto; Brizuela, Matias; Balasini, Carina; Mare, Sebastián; Domeniconi, G.; Ilutovich, Santiago; Gómez, Alejandro; Giuliani, Javiera; Barrios, Cecilia; Valdez, Pascual

doi:10.1164/201001-0037oc

Cited by 207 publications

(100 citation statements)

References 41 publications

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“…Differences with other studies might be related to our critically ill population, for whom the criteria were standardized on the basis of AKIN criteria. Finally, mortality rates of 16%, 19% and 54%, respectively, have been reported among critically ill patients with H1N1 virus infection in Brazil [33], Argentina [5] and Canada [3]. The main difference is that in the present study, although the mortality rate was 18.8% and significantly higher for patients who developed AKI, multivariate analysis demonstrated that only AKIN stage III was independently associated with ICU mortality.…”

Section: Discussioncontrasting

confidence: 60%

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Acute kidney injury in critical ill patients affected by influenza A (H1N1) virus infection

et al. 2011

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IntroductionLittle information exists about the impact of acute kidney injury (AKI) in critically ill patients with the pandemic 2009 influenza A (H1N1) virus infection.MethodsWe conducted a prospective, observational, multicenter study in 148 Spanish intensive care units (ICUs). Patients with chronic renal failure were excluded. AKI was defined according to Acute Kidney Injury Network (AKIN) criteria.ResultsA total of 661 patients were analyzed. One hundred eighteen (17.7%) patients developed AKI; of these, 37 (31.4%) of the patients with AKI were classified as AKI I, 15 (12.7%) were classified as AKI II and 66 (55.9%) were classified as AKI III, among the latter of whom 50 (75.7%) required continuous renal replacement therapy. Patients with AKI had a higher Acute Physiology and Chronic Health Evaluation II score (19.2 ± 8.3 versus 12.6 ± 5.9; P < 0.001), a higher Sequential Organ Failure Assessment score (8.7 ± 4.2 versus 4.8 ± 2.9; P < 0.001), more need for mechanical ventilation (MV) (87.3% versus 56.2%; P < 0.01, odds ratio (OR) 5.3, 95% confidence interval (CI) 3.0 to 9.4), a greater incidence of shock (75.4% versus 38.3%; P < 0.01, OR 4.9, 95% CI, 3.1 to 7.7), a greater incidence of multiorgan dysfunction syndrome (92.4% versus 54.7%; P < 0.01, OR 10.0, 95% CI, 4.9 to 20.21) and a greater incidence of coinfection (23.7% versus 14.4%; P < 0.01, OR 1.8, 95% CI, 1.1 to 3.0). In survivors, patients with AKI remained on MV longer and ICU and hospital length of stay were longer than in patients without AKI. The overall mortality was 18.8% and was significantly higher for AKI patients (44.1% versus 13.3%; P < 0.01, OR 5.1, 95% CI, 3.3 to 7.9). Logistic regression analysis was performed with AKIN criteria, and it demonstrated that among patients with AKI, only AKI III was independently associated with higher ICU mortality (P < 0.001, OR 4.81, 95% CI 2.17 to 10.62).ConclusionsIn our cohort of patients with H1N1 virus infection, only those cases in the AKI III category were independently associated with mortality.

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Section: Discussioncontrasting

confidence: 60%

“…However, the information regarding the incidence and impact of renal failure among these patients remains scarce. The World Health Organization (WHO) warned physicians that patients H1N1 virus infection might develop renal impairment ranging from just mild disease to the need for renal replacement therapy (RRT) [1-5]. …”

Section: Introductionmentioning

confidence: 99%

Acute kidney injury in critical ill patients affected by influenza A (H1N1) virus infection

et al. 2011

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“…Several previous studies of A/H1N1 reported that one of the most important risk factors for complications of severe illness with A/H1N1 infection were age [10,27-29]. In the current study, however, age was not a significant factor associated with rapid disease progression of A/H1N1 infection in children.…”

Section: Discussioncontrasting

confidence: 75%

The value of radiographic findings for the progression of pandemic 2009 influenza A/H1N1 virus infection

et al. 2013

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BackgroundMost illnesses caused by pandemic influenza A (H1N1) pdm09 virus (A/H1N1) infection are acute and self-limiting among children. However, in some children, disease progression is rapid and may require hospitalization and transfer to a pediatric intensive care unit (PICU). We investigated factors associated with rapid disease progression among children admitted to hospital for A/H1N1 infection, particularly findings on initial chest radiographs.MethodsIn this retrospective study, we investigated the records of children who had received a laboratory or clinical diagnosis of A/H1N1 infection and were admitted to the largest children’s hospital in Japan between May 2009 and March 2010. The medical records were reviewed for age, underlying diseases, vital signs on admission, initial chest radiographic findings, and clinical outcomes. According to chest radiographic findings, patients were classified into 4 groups, as follows: [1] normal (n = 46), [2] hilar and/or peribronchial markings alone (n = 64), [3] consolidation (n = 64), and [4] other findings (n = 29). Factors associated with clinical outcomes were analyzed using logistic regression.ResultsTwo hundreds and three patients (median 6.8 years) were enrolled in this study. Fifteen percent (31/203) of patients were admitted to PICU. Among 31 patients, 39% (12/31) of patients required mechanical ventilation (MV). When the initial chest radiographic findings were compared between patients with consolidation (n = 64) and those without consolidation (n = 139), a higher percentage of patients with consolidation were admitted to PICU (29.7% vs.8.6%, P < 0.001) and required MV (17.2% vs. 0.7%, P < 0.001). These findings remain significant when the data were analyzed with the logistic regression (P < 0.001, P < 0.001, respectively).ConclusionsConsolidation on initial chest radiographs was the most significant factor to predict clinical course of hospitalized children with the 2009 A/H1N1 infection.

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“…In addition, immunosuppression was a main risk factor for early mortality among 337 Argentinean patients admitted to ICU with influenza like illness and respiratory failure that required mechanical ventilation. Mortality was highly associated with refractory hypoxemia 25 . These data explain our high mortality rate observed among the 17 patients who were admitted to ICU (11/17; 65%) or among the 12 patients who developed respiratory failure (11/12; 92%).…”

Section: Discussionmentioning

confidence: 99%

Pandemic 2009 Influenza A (H1N1) virus infection in cancer and hematopoietic stem cell transplant recipients; a multicenter observational study.

Dignani¹,

Costantini

Salgueira

et al. 2015

F1000Res

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Pandemic 2009 Influenza A in Argentina

Cited by 207 publications

References 41 publications

Acute kidney injury in critical ill patients affected by influenza A (H1N1) virus infection

Acute kidney injury in critical ill patients affected by influenza A (H1N1) virus infection

The value of radiographic findings for the progression of pandemic 2009 influenza A/H1N1 virus infection

Pandemic 2009 Influenza A (H1N1) virus infection in cancer and hematopoietic stem cell transplant recipients; a multicenter observational study.

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