Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Influenza Other Respir Viruses. 2012 Nov;6(6):e134-42. doi: 10.1111/j.1750-2659.2012.00385.x. Epub 2012 Jun 6.
The influenza A (H1N1pdm09) [pH1N1] virus resulted in intensive care unit (ICU) admissions, acute respiratory distress syndrome (ARDS), and death.
To describe the characteristics of ICU patients with pH1N1 virus infection in the United States during the spring and fall of 2009 and to describe the factors associated with severe complications including ARDS and death.
PATIENTS/METHODS: Through two national case-series conducted during spring and fall of 2009, medical charts were reviewed on ICU patients with laboratory-confirmed pH1N1 infection by real-time reverse-transcriptase polymerase chain reaction.
The majority (77%) of 154 patients hospitalized in an ICU were <50 years of age, and 65% had at least one underlying medical condition. One hundred and twenty-eight (83%) patients received influenza antiviral agents; 29% received treatment ≤ 2 days after illness onset. Forty-eight (38%) patients developed ARDS and 37 (24%) died. Patients with ARDS were more likely to be morbidly obese (36% versus 19%, P=0.04) and patients who died were less likely to have asthma (11% versus 28%, P=0.05). Compared with patients who received treatment ≥ 6 days after illness onset, patients treated ≤ 2 days after illness onset were less likely to develop ARDS (17% versus 37%, P<0.01) or die (7% versus 35%, P<0.01).
Among patients hospitalized in an ICU with pH1N1 virus infection, ARDS was a common complication, and one-quarter of patients died. Patients with asthma had less severe outcomes. Early treatment with influenza antiviral agents was likely beneficial, especially when initiated ≤ 2 days after illness onset.
甲型 H1N1（pH1N1）病毒导致重症监护病房（ICU）收治、急性呼吸窘迫综合征（ARDS）和死亡。
描述 2009 年春季和秋季美国 pH1N1 病毒感染 ICU 患者的特征，并描述与严重并发症（包括 ARDS 和死亡）相关的因素。
患者/方法：通过 2009 年春季和秋季进行的两项全国性病例系列研究，对经实时逆转录酶聚合酶链反应（PCR）实验室确诊 pH1N1 感染的 ICU 患者的病历进行了回顾。
154 名住院 ICU 的患者中，大多数（77%）年龄<50 岁，65%有至少一种基础疾病。128 名（83%）患者接受了流感抗病毒药物治疗；29%的患者在发病后≤2 天接受治疗。48 名（38%）患者发生 ARDS，37 名（24%）死亡。发生 ARDS 的患者更可能为病态肥胖（36%比 19%，P=0.04），而死亡的患者更可能没有哮喘（11%比 28%，P=0.05）。与发病后接受治疗≥6 天的患者相比，发病后≤2 天接受治疗的患者发生 ARDS 的可能性较低（17%比 37%，P<0.01）或死亡的可能性较低（7%比 35%，P<0.01）。
在因 pH1N1 病毒感染住院的 ICU 患者中，ARDS 是常见的并发症，四分之一的患者死亡。有哮喘的患者结局较轻。早期使用流感抗病毒药物可能有益，尤其是在发病后≤2 天开始治疗时。
