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2009 年 H1N1 流感与三家重症监护病房的经验

2009 H1N1 influenza and experience in three critical care units.

机构信息

Selcuk University, Meram Medical Faculty, Pulmonary Diseases and Critical Care Department, 42080, Konya, Turkey.

出版信息

Int J Med Sci. 2011 Apr 7;8(3):270-7. doi: 10.7150/ijms.8.270.

Abstract

AIM

We describe futures of ICU admission, demographic characteristics, treatment and outcome for critically ill patients with laboratory-confirmed and suspected infection with the H1N1 virus admitted to the three different critical care departments in Turkey.

METHODS

Retrospective study of critically ill patients with 2009 influenza A(H1N1) at ICU. Demographic data, symptoms, comorbid conditions, and clinical outcomes were collected using a case report form.

RESULTS

Critical illness occurred in 61 patients admitted to an ICU with confirmed (n=45) or probable and suspected 2009 influenza A(H1N1). Patients were young (mean, 41.5 years), were female (54%). Fifty-six patients, required mechanical ventilation (14 invasive, 27 noninvasive, 15 both) during the course of ICU. On admission, mean APACHE II score was 18.7±6.3 and median PaO(2)/FIO(2) was 127.9±70.4. 31 patients (50.8%) was die. There were no significant differences in baseline PaO(2)/FIO(2 )and ventilation strategies between survivors and nonsurvivors. Patients who survived were more likely to have NIMV use at the time of admission to the ICU.

CONCLUSION

Critical illness from 2009 influenza A(H1N1) in ICU predominantly affects young patients with little major comorbidity and had a high case-fatality rate. NIMV could be used in 2009 influenza A (H1N1) infection-related hypoxemic respiratory failure.

摘要

目的

我们描述了在土耳其的三个不同重症监护病房中,确诊和疑似感染 H1N1 病毒的危重症患者的 ICU 入院、人口统计学特征、治疗和结局的未来。

方法

对 ICU 中确诊的 2009 年甲型 H1N1 流感危重症患者进行回顾性研究。使用病例报告表收集人口统计学数据、症状、合并症和临床结局。

结果

61 例确诊(n=45)或疑似和可疑的 2009 年甲型 H1N1 流感患者入住 ICU 发生危重症。患者年龄较小(平均年龄 41.5 岁),女性占 54%。56 例患者在 ICU 期间需要机械通气(14 例有创,27 例无创,15 例两者兼有)。入院时,平均急性生理和慢性健康评分 II(APACHE II)为 18.7±6.3,氧分压/吸入氧分数(PaO(2)/FIO(2))中位数为 127.9±70.4。31 例(50.8%)患者死亡。存活组和死亡组在入院时的 PaO(2)/FIO(2)和通气策略方面无显著差异。存活患者在入住 ICU 时更有可能使用无创通气(NIMV)。

结论

ICU 中由 2009 年甲型 H1N1 引起的危重症主要影响年轻患者,合并症较少,但病死率较高。NIMV 可用于 2009 年甲型 H1N1(H1N1)感染相关低氧性呼吸衰竭。

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