Source: Annual Congress 2010 - Influenza A (H1N1) and other viral infections: therapeutic aspects
Disease area: Respiratory infections

Abstract

We broadly present clinical and prognostic features of patients admitted to intensive care unit with pandemic H1N1 2009 Outbreak.
Patients who were admitted to the intensive care unit of a university hospital in Turkiye between November and early December, 2009 and had influenza associated severe to very severe pneumonia were evaluated.
The study included 20 patients (10 male, 10 female) with the mean age of 36, 80% of whom had very severe CAP and ARDS. Cardinal symptoms were fever, myalgias, and hemoptysis with the rates of 85%, 75% and 45%, respectively. Bilateral ground glass opacities were seen in the 50% of lung roentgenograms. Main laboratory findings were normal leukocyte count, lymphopenia, higher creatin phosphokinase and LDH levels, and moderately high AST and CRP levels. Overall, 17 patients (85%) had H1N1 positivity on RT-PCR assay. Nine patients having underlying diseases with ARDS, eight entubated and one not entubated, have died. Two perviously healthy young adult patients with ARDS were entubated and have survived. Five patients with early ARDS were not entubated and have also survived. These patients also had underlying conditions. None of the patients had H1N1 vaccination. None of them had taken oseltamivir within 48 hours. Main reasons for mortality were cardiovasculary complications and ventilatory associated pneumonia due to Acynetobacter baumannii.
It is concluded that higher mortality was strongly associated with the presence of underlying conditions, and possibly late administiration of antiviral agents, and finally multidrug resistant microorganism related ventilatory associated pneumonia.

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B. Ozbay, B. Sertogullarindan, H. Gunbatar, A. Sunnetcioglu, A. Arisoy, M. H. Bilgin, B. Mermit, M. Duran, H. Yildiz, A. I. Baran (Van, Turkey). Clinical and prognostic features of patients admitted to intensive care unit with pandemic H1N1 2009 Outbreak. Eur Respir J 2010; 36: Suppl. 54, 2977

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