Description of our experience in the management of 2009A/H1N1 pneumonia
R. M. Purificación, R. Pitti Pérez, L. Eiroa González, L. Pérez Negrín, A. Pérez Rodríguez, M. L. Padilla Salazar, J. Rodríguez González, M. C. Hernández Gracia, J. J. Batista Martín (Santa Cruz de Tenerife, Spain)
Source: Annual Congress 2010 - Influenza A (H1N1) and other viral infections: therapeutic aspects
Disease area: Respiratory infections
Abstract This new virus of the influenza has affected of singular way, producing in some patients quickly lethal progressive pneumonia.The objective of this work is to describe our experience in the management of the patients entered the our hospital with pneumonia by H1N1 that not requiered admit in ICU (71/83).The age average was of 39 years.46% whitout risk factors.80% belonged to classes I and II of Fine,nevertheless the respiratory frequency was 27,pO2 average of 61 and presented bilateral affectation in 55%.They were diagnosed by means of detection of antigen in nasopharyngeal swab 37,PCR in the same sample18, bronchoscopy(BF)14,and serology 2.We have found coinfection by neumococcus in 2/21,and initially positive serology for atypicals 18/55.All patients received treatment with antibiotics,steroids and oseltamivir,associated to zanamivir in the serious cases.They required noninvasive ventilation 9,of which 1 was been intubated and trasladated to ICU.All patients were discharged. Its average stay was of 8,8 days.The complications attributed to the infection besides the pneumonia were,respiratory insufficiency 33,exacerbation of asthma/COPD 10,renal failure 3,and presence of images in HRCT of suggestives of BOOP 5.No we even had no contagius between the staff.Our patients resemble others series,unless the findings of coinfections.The scale of Fine probably does not reflect the real severity maybe we must play attention at the respiratory frequency and the affectation to mulitilobar for estimate the severity. In our experience, as much the BF as NIV has shown to be technical safe.It is possible that the use of the NIV reduced the costs,the average stay and the complications derived from orotracheal intubation.
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R. M. Purificación, R. Pitti Pérez, L. Eiroa González, L. Pérez Negrín, A. Pérez Rodríguez, M. L. Padilla Salazar, J. Rodríguez González, M. C. Hernández Gracia, J. J. Batista Martín (Santa Cruz de Tenerife, Spain). Description of our experience in the management of 2009A/H1N1 pneumonia. Eur Respir J 2010; 36: Suppl. 54, 2981
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