Sigurdsson Gísli H, Möller Alma D, Kristinsson Bjarki, Gudlaugsson Olafur, Kárason Sigurbergur, Sigurdsson Sigurdur E, Kristjánsson Mar, Sigvaldason Kristin
Laeknabladid. 2010 Feb;96(2):83-90. doi: 10.17992/lbl.2010.02.09.
We describe the main characteristics of patients that required intensive care due to the influenza (H1N1) outbreak in 2009.
Retrospective and prospective analysis of medical records from patients admitted to ICU with positive RT-PCR for (H1N1).
During a six week period in the fall of 2009, 16 patients were admitted to intensive care in Iceland with confirmed H1N1 infection. Mean age was 48 years (range 1-81). Most patients were considered quite healthy but the majority had risk factors such as smoking, obesity or hypertension. All but one had fever, cough, dyspnea and bilateral infiltrates on chest x-ray and developed any organ failures (mean SOFA score 7). 12 needed mechanical ventilation and two extra corporeal membrane oxygenation (ECMO). Mean APACHE II score was 20. No patient died in the ICU but one elderly patient with multiple underlying diseases died a few days after being discharged from the ICU.
(1) The incidence of severe influenza A (H1N1) that leads to ICU admission appears to be high in Iceland. (2) Many patients developed acute respiratory distress syndrome in addition to other organ failures, and required additional measures for oxygenation such as prone position, nitric oxide inhalation and ECMO. (3) 28 day mortality was low. (4) This study will aid in future outbreak planning in Iceland. Key words: influenza A, pneumonia, multiple organ failure, death rate, intensive care, ventilator therapy, ECMO.
我们描述了2009年因甲型H1N1流感爆发而需要重症监护的患者的主要特征。
对入住重症监护病房且实时荧光定量聚合酶链反应（RT-PCR）检测甲型H1N1呈阳性的患者的病历进行回顾性和前瞻性分析。
在2009年秋季的六周时间里，冰岛有16例确诊感染甲型H1N1的患者入住重症监护病房。平均年龄为48岁（范围1 - 81岁）。大多数患者原本被认为相当健康，但大多数人有吸烟、肥胖或高血压等危险因素。除一人外，所有患者均有发热、咳嗽、呼吸困难，胸部X光显示双侧浸润，并出现任何器官功能衰竭（序贯器官衰竭评估（SOFA）评分平均为7分）。12例患者需要机械通气，2例需要体外膜肺氧合（ECMO）。急性生理与慢性健康状况评分系统（APACHE II）平均评分为20分。重症监护病房内无患者死亡，但一名患有多种基础疾病的老年患者在从重症监护病房出院几天后死亡。
（1）在冰岛，导致入住重症监护病房的严重甲型H1N1流感的发病率似乎很高。（2）许多患者除了其他器官功能衰竭外，还出现了急性呼吸窘迫综合征，需要采取额外的氧合措施，如俯卧位、吸入一氧化氮和体外膜肺氧合。（3）28天死亡率较低。（4）本研究将有助于冰岛未来的疫情防控规划。关键词：甲型流感、肺炎、多器官功能衰竭、死亡率、重症监护、呼吸机治疗、体外膜肺氧合
