Potential Intensive Care unit Ventilator Demand/Capacity Mismatch due to Novel Swine‐Origin H1N1 in Canada

Smetanin, Paul; Stiff, David; Kumar, Anand; Kobak, Paul; Zarychanski, Ryan; Simonsen, Neil; Plummer, Frank

doi:10.1155/2009/808209

Cited by 24 publications

(26 citation statements)

References 11 publications

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“…An important "therapeutic gap" therefore exists, and novel drugs are needed to either delay the onset of ARDS or reduce its severity in this cohort of influenza-infected patients. Such drugs could reduce the potential for ICU overload in pandemic situations (29,30), maintaining the ability of the healthcare system to provide adequate care to all who require it (12,14).…”

Section: Discussionmentioning

confidence: 99%

Postinfection A77-1726 Treatment Improves Cardiopulmonary Function in H1N1 Influenza-Infected Mice

Aeffner¹,

Bratasz

Flaño

et al. 2012

Am J Respir Cell Mol Biol

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Section: Discussionmentioning

confidence: 99%

Postinfection A77-1726 Treatment Improves Cardiopulmonary Function in H1N1 Influenza-Infected Mice

Aeffner¹,

Bratasz

Flaño

et al. 2012

Am J Respir Cell Mol Biol

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“…Future analysis may help to refine this threshold and thus may have to take into account how long it is exceeded. The magnitude of a pandemic and its consequences on the organization of a health-care system depend on several parameters and are notoriously difficult to predict [21,22]. Therefore, experiences reported during the first waves throughout the world were useful to better elaborate forecasts taking into account different attack rates and epidemic wave durations [23,24].…”

Section: Discussionmentioning

confidence: 99%

Interest of a simple on-line screening registry for measuring ICU burden related to an influenza pandemic

et al. 2012

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IntroductionThe specific burden imposed on Intensive Care Units (ICUs) during the A/H1N1 influenza 2009 pandemic has been poorly explored. An on-line screening registry allowed a daily report of ICU beds occupancy rate by flu infected patients (Flu-OR) admitted in French ICUs.MethodsWe conducted a prospective inception cohort study with results of an on-line screening registry designed for daily assessment of ICU burden.ResultsAmong the 108 centers participating to the French H1N1 research network on mechanical ventilation (REVA) - French Society of Intensive Care (SRLF) registry, 69 ICUs belonging to seven large geographical areas voluntarily participated in a website screening-registry. The aim was to daily assess the ICU beds occupancy rate by influenza-infected and non-infected patients for at least three weeks. Three hundred ninety-one critically ill infected patients were enrolled in the cohort, representing a subset of 35% of the whole French 2009 pandemic cohort; 73% were mechanically ventilated, 13% required extra corporal membrane oxygenation (ECMO) and 22% died. The global Flu-OR in these ICUs was only 7.6%, but it exceeded a predefined 15% critical threshold in 32 ICUs for a total of 103 weeks. Flu-ORs were significantly higher in University than in non-University hospitals. The peak ICU burden was poorly predicted by observations obtained at the level of large geographical areas.ConclusionsThe peak Flu-OR during the pandemic significantly exceeded a 15% critical threshold in almost half of the ICUs, with an uneven distribution with time, geographical areas and between University and non-University hospitals. An on-line assessment of Flu-OR via a simple dedicated registry may contribute to better match resources and needs.

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“…Pediatric caregivers in Canada were often overworked as admissions rose. After the experience in Manitoba, Canada, where ICUs were nearly overwhelmed with critically ill patients during the first wave of the pandemic, a stockpile of ventilators was increased in some jurisdictions in order to help face such a sudden increase in critically ill patients in other areas [50,101]. In order to estimate the risk of mismatch between demand and capacity of PICUs, a modeling exercise was performed with different attack rates.…”

Section: Disease Burden On Healthcare Resourcesmentioning

confidence: 99%

“…Some studies performed using data from the first wave suggested a possible mismatch between resources (e.g., ventilators and PICU beds) and care demands [50,51]. To improve forecasting, it will be necessary to improve real-time data collection and further delineate geography-and population-specific risks.…”

Section: Adaptation Of Health Resources To Pandemic Burdenmentioning

confidence: 99%

H1N1 pandemic: clinical and epidemiologic characteristics of the Canadian pediatric outbreak

Fléchelles

Fowler

Jouvet

2013

Expert Review of Anti-infective Therapy

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Canada was one of the first countries affected by the 2009 influenza H1N1 pandemic with two waves - one from May to June and one from October to December. The 2009 influenza H1N1 pandemic had many unique features when compared with seasonal influenza, including the following: more than half of the affected people were children; asthma was the most significant risk factor for hospital admission; and Aboriginal and pregnant women had a higher risk of hospital admission and complications. Antiviral therapy was widely used but data did not show any effect on the pediatric population. Outbreak spread was possibly promoted from child-child and child-adult contact, and therefore the vaccination campaign targeted the pediatric population and achieved good coverage among young children (57%). Vaccination efficacy was difficult to test because of the vaccination delay. Improvement in models of prevention and treatment are urgently needed to prepare for the possible future pandemics.

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Potential Intensive Care unit Ventilator Demand/Capacity Mismatch due to Novel Swine‐Origin H1N1 in Canada

Abstract: Canada's health care system must be prepared for the possibility of a significant influx of ICU patients during the second wave of swine-origin H1N1. Efficient vaccination and other disease prevention measures can reduce the attack rate to manageable levels.

Cited by 24 publications

References 11 publications

Postinfection A77-1726 Treatment Improves Cardiopulmonary Function in H1N1 Influenza-Infected Mice

Postinfection A77-1726 Treatment Improves Cardiopulmonary Function in H1N1 Influenza-Infected Mice

Interest of a simple on-line screening registry for measuring ICU burden related to an influenza pandemic

H1N1 pandemic: clinical and epidemiologic characteristics of the Canadian pediatric outbreak

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