Department of Allergy, Immunology, and Respiratory Medicine, The Alfred Hospital, Melbourne, Australia.
Semin Respir Crit Care Med. 2011 Aug;32(4):400-8. doi: 10.1055/s-0031-1283280. Epub 2011 Aug 19.
During the Northern Hemisphere spring of 2009, a novel H1N1 influenza A virus emerged in Mexico, causing widespread human infection and acute critical respiratory illness. The 2009 H1N1 virus spread initially to the United States and Canada, with subsequent rapid global dissemination, leading the World Health Organization (WHO) to declare "a public health emergency of international concern" in April 2009, and upgrading the viral threat to pandemic status in June 2009. Despite initial fears, the severity of the 2009 H1N1 pandemic overall did not differ significantly from that of seasonal influenza. However, the demographics of those at risk of severe illness did differ (affecting children and young adults, rather than the very young and the very old). The 2009 H1N1 pandemic led to rapid implementation of health care initiatives, including the provision of critical care services, to limit the effect of the influenza outbreak on the community. This review focuses on the critical care response to the H1N1 pandemic and examines whether the implementation of critical care services as planned a priori matched the reality of the clinical workload and the patient burden that transpired during the 2009 H1N1 influenza pandemic.
2009 年北半球春季，一种新型 H1N1 甲型流感病毒在墨西哥出现，导致广泛的人类感染和急性严重呼吸道疾病。2009 年 H1N1 病毒最初传播到美国和加拿大，随后迅速在全球传播，世界卫生组织（WHO）于 2009 年 4 月宣布“国际关注的突发公共卫生事件”，并于 2009 年 6 月将病毒威胁升级为大流行状态。尽管最初存在担忧，但 2009 年 H1N1 大流行的总体严重程度与季节性流感没有显著差异。然而，患病风险较高的人群的特征确实有所不同（影响儿童和年轻人，而不是非常年幼和非常年老的人）。2009 年 H1N1 大流行导致迅速实施医疗保健措施，包括提供重症监护服务，以限制流感爆发对社区的影响。本综述重点关注对 H1N1 大流行的重症监护反应，并检查在 2009 年 H1N1 流感大流行期间，重症监护服务的实施是否按照事先计划的方案与实际临床工作量和患者负担相匹配。
