Patel M, Dennis A, Flutter C, Thornton S, D'Mello O, Sherwood N
Anaesthesia and Intensive Care, City Hospital, Birmingham, UK.
Anaesthesia. 2009 Nov;64(11):1241-5. doi: 10.1111/j.1365-2044.2009.06128.x.
This case series details experience of critical care admissions with pandemic (H1N1) 2009 influenza from an intensive care unit in the West Midlands. We present four critically ill patients admitted with severe hypoxia. Two of the patients failed a trial of continuous positive airway pressure and all underwent controlled ventilation within 24 h of admission. Bilevel and high frequency oscillatory ventilation were the most useful modes. Our patients generally had one organ failure and were ventilator dependent for relatively short periods of time. Three of the patients made a full recovery and one required ongoing dialysis. We also discuss service planning and our response to the pandemic. We were well prepared with stocks of personal protective equipment but had to modify plans as the outbreak progressed. Our cases and discussion provide useful information for other intensive care units preparing for the predicted autumn surge of H1N1 cases.
本病例系列详细介绍了西米德兰兹郡一家重症监护病房收治2009年甲型H1N1流感危重症患者的经验。我们呈现了4例因严重低氧血症入院的危重症患者。其中2例患者持续气道正压通气试验失败，所有患者在入院24小时内均接受了控制性通气。双水平通气和高频振荡通气是最有效的通气模式。我们的患者一般有一个器官功能衰竭，且呼吸机依赖时间相对较短。3例患者完全康复，1例需要持续透析治疗。我们还讨论了服务规划以及我们对疫情的应对措施。我们储备了充足的个人防护装备，但随着疫情的发展不得不调整计划。我们的病例及讨论为其他重症监护病房应对预计秋季出现的甲型H1N1流感病例激增情况提供了有用信息。
