Pandemic and post-pandemic Influenza A (H1N1) infection in critically ill patients 英文参考文献.docVIP

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Pandemic and post-pandemic Influenza A (H1N1) infection in critically ill patients 英文参考文献.doc

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Pandemic and post-pandemic Influenza A (H1N1) infection in critically ill patients 英文参考文献

Martin-Loechesetal.CriticalCare2011,15:R286 /content/15/6/R286 RESEARCH OpenAccess Pandemicandpost-pandemicInfluenzaA(H1N1) infectionincriticallyillpatients IgnacioMartin-Loeches1,2*,EmiliDíaz2,LoretoVidaur3,AntoniTorres4,CesarLaborda5,RosaGranada6,JuanBonastre7, MarMartín8,JosuInsausti9,AngelArenzana10,JoseEugenioGuerrero11,InesNavarrete12,JesusBermejo-Martin13, DavidSuarez14andAlejandroRodriguez2,fortheH1N1SEMICYUC/REIPI/CIBERESWorkinggroup Abstract Background:Thereisavastamountofinformationpublishedregardingtheimpactof2009pandemicInfluenzaA (pH1N1)virusinfection.However,acomparisonofriskfactorsandoutcomeduringthe2010-2011post-pandemic periodhasnotbeendescribed. Methods:Aprospective,observational,multi-centerstudywascarriedouttoevaluatetheclinicalcharacteristics anddemographicsofpatientswithpositiveRT-PCRforH1N1admittedto148Spanishintensivecareunits(ICUs). Datawereobtainedfromthe2009pandemicandcomparedtothe2010-2011post-pandemicperiod. Results:Ninehundredandninety-sevenpatientswithconfirmedAn/H1N1infectionwereincluded.Sixhundred andforty-eightpatientsaffectedby2009(pH1N1)virusinfectionand349patientsaffectedbythepost-pandemic Influenza(H1N1)vinfectionperiodwereanalyzed.Patientsduringthepost-pandemicperiodwereolder,hadmore chroniccomorbidconditionsandpresentedwithhigherseverityscores(AcutePhysiologyAndChronicHealth EvaluationII(APACHEII)andSequentialOrganFailureAssessment(SOFA))onICUadmission.Patientsfromthe post-pandemicInfluenza(H1N1)vinfectionperiodreceivedempiricantiviraltreatmentlessfrequentlyandwith delayedadministration.Mortalitywassignificantlyhigherinthepost-pandemicperiod.Multivariateanalysis confirmedthathaematologicaldisease,invasivemechanicalventilationandcontinuousrenalreplacementtherapy werefactorsindependentlyassociatedwithworseoutcomeinthetwoperiods.HIVwastheonlynewvariable independentlyassociatedwithhigherICUmortalityduringthepost-pandemicInfluenza(H1N1)vinfectionperiod. Conclusion:Patientsfromthepost-pandemicInfluenza(H1N1)vinfectionperiodhadanu