Use of early corticosteroid therapy on ICU admission in patients affected by severe pandemic (H1N1)v influenza A infection

Martín‐Loeches, Ignacio; Lisboa, Thiago; Rhodes, Andrew; Moreno, Rui P.; Silva, E.; Sprung, Charles L.; Chiche, Jean‐Daniel; Barahona, D.; Villabon, Mario; Balasini, Carina; Pearse, Rupert M; Matos, Ricardo; Rello, Jordi

doi:10.1007/s00134-010-2078-z

Cited by 186 publications

(195 citation statements)

References 50 publications

(41 reference statements)

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“…We only rarely used combination antiviral therapy, because this is experimental and has so far not demonstrated any benefit 16. Corticosteroids were not routinely used, as this may add to the risk of a worse outcome 19, 20 …”

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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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: 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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“…The commonly applied therapeutics included antiviral (mostly Tamiflu/ Oseltamivir) and corticosteroid treatments [18]. While controversy regarding the drug efficacy of corticosteroids in the treatment of acute respiratory distress syndrome patients infected with 2009 pandemic H1N1 has been reported [19,20], the effects of Tamiflu treatment at an early stage of disease-onset are well-established [21][22][23]. Using our newly established mouse model, infected with the 2009 pandemic BJ501 strain, we tested the drug efficacy of Oseltamivir.…”

Section: Administration Of Oseltamivir At Early Stages Of Infection Amentioning

confidence: 99%

IL-17 response mediates acute lung injury induced by the 2009 Pandemic Influenza A (H1N1) Virus

et al. 2011

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“…The use of corticosteroids for the treatment of critical cases with H1N1 infection in the ICU has come into practice 2,8,17,[29][30][31] . In cases of respiratory impairment associated with serious H1N1 infection, corticosteroid use has been reported as 51%-69% 7,8 .…”

mentioning

confidence: 99%

“…, others have administered corticosteroids in the early stages of infection to all patients admitted to the ICU with H1N1 infection 30 . It has been suggested that the early stage administration of corticosteroids has not improved prognosis 27 and has even increased the risk of superinfection 30 .…”

mentioning

confidence: 99%

A retrospective evaluation of critically ill patients infected with H1N1 influenza A virus in Bursa, Turkey, during the 2009–2010 pandemic

Nermin¹,

İşçimen²,

Zeynep³

et al. 2015

Afr H. Sci.

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Background: H1N1 influenza A virus infections were first reported in April 2009 and spread rapidly, resulting in mortality worldwide. The aim of this study was to evaluate patients with H1N1 infection treated in the intensive care unit (ICU) in Bursa, Turkey. Methods: Demographic characteristics, clinical features, and outcome relating to H1N1 infection were retrospectively analysed in patients treated in the ICU. Results: Twenty-three cases of H1N1 infection were treated in the ICU. The mean age of patients was 37 years range: (17-82). Fifteen patients were female (65.2%). The mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 19 range: (5-39). The most common symptoms were dyspnea (73.9%), fever (69.6%), and cough (60.9%). Mechanical ventilation was required for all patients. Oseltamivir and antibiotics were administered to all patients. Six (26.1%) patients died. APACHE II scores were higher in the deceased 28.5 range: vs. 14 range: in survivors; p = 0.013). Conclusion: When compared to the literature, the demographic, epidemiological, and clinical characteristics were similar in the cases we encountered. The mortality rate was high despite the use of appropriate treatment. We believe that the high mortality is related to higher APACHE II scores. The H1N1 virus should be considered in community acquired pneumonia, especially in younger patients presenting with severe pneumonia.

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Use of early corticosteroid therapy on ICU admission in patients affected by severe pandemic (H1N1)v influenza A infection

Abstract: Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection did not result in better outcomes and was associated with increased risk of superinfections.

Cited by 186 publications

References 50 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

IL-17 response mediates acute lung injury induced by the 2009 Pandemic Influenza A (H1N1) Virus

A retrospective evaluation of critically ill patients infected with H1N1 influenza A virus in Bursa, Turkey, during the 2009–2010 pandemic

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