由于新型猪源 H1N1 流感在加拿大造成的潜在重症监护病房呼吸机需求/能力不匹配。
Potential intensive care unit ventilator demand/capacity mismatch due to novel swine-origin H1N1 in Canada.
机构信息
RiskAnalytica Research, Toronto, Ontario;
出版信息
Can J Infect Dis Med Microbiol. 2009 Winter;20(4):e115-23. doi: 10.1155/2009/808209.
PURPOSE
To investigate the ability of Canadian intensive care units (ICUs) and ventilators to handle widespread re-emergence of the swine-origin H1N1 virus in the context of an aggressive strategy of vaccination.
METHOD
Data collected during the first wave in Winnipeg, Manitoba, were applied to a variety of second wave pandemic models to determine potential ICU and ventilator demand.
RESULTS
For attack rates greater than 20% to 25%, significant shortages in ventilators may be expected across Canada regardless of the duration of the pandemic if vaccination is not considered. The shortfall arises largely due to the extended durations that patients must remain on ventilation. From the Winnipeg study, 50% of patients required ventilation for more than two weeks. For larger attack rates of 35%, ventilator demand may exceed capacity for over five weeks, with a peak shortfall of 700 ventilators. Vaccination can significantly reduce the attack rates, and is expected to reduce ventilator demand to manageable levels
CONCLUSION
Canada's health care system must be prepared for the possibility of a significant influx of ICU patients during the second wave of swine-origin H1N1. Efficient vaccination and other disease prevention measures can reduce the attack rate to manageable levels.
目的
在积极接种疫苗的策略背景下，研究加拿大重症监护病房（ICU）和呼吸机应对猪源 H1N1 病毒广泛再次出现的能力。
方法
将在马尼托巴省温尼伯市第一波疫情期间收集的数据应用于各种第二波大流行模型，以确定潜在的 ICU 和呼吸机需求。
结果
如果不考虑接种疫苗，在加拿大，无论大流行持续时间长短，对于发病率超过 20%至 25%的情况，预计呼吸机可能会出现严重短缺。这种短缺主要是由于患者必须长时间接受呼吸机治疗。从温尼伯的研究中可以看出，50%的患者需要呼吸机治疗两周以上。对于发病率更高的 35%，呼吸机的需求可能会超过五周，峰值短缺达到 700 台。接种疫苗可以显著降低发病率，并有望将呼吸机的需求降低到可控水平。
结论
加拿大的医疗保健系统必须为第二波猪源 H1N1 流感期间可能大量涌入 ICU 患者做好准备。有效的疫苗接种和其他疾病预防措施可以将发病率降低到可控水平。
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