Characteristics and outcome of mechanically ventilated patients with 2009 H1N1 influenza in Bosnia and Herzegovina and Serbia: impact of newly established multidisciplinary intensive care units

To describe characteristics and outcome of mechanically ventilated patients admitted to three newly established intensive care units (ICU) in Bosnia-Herzegovina and Serbia for 2009 H1N1 influenza infection. The retrospective observational study included all mechanically ventilated adult patients of...

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Bibliographic Details
Published in:Croatian medical journal 2012-12, Vol.53 (6), p.620-627
Main Authors: Kojicić, Marija, Kovacević, Pedja, Bajramović, Nermina, Batranović, Uros, Vidović, Jadranka, Aganović, Kenana, Gavrilović, Srdjan, Zlojutro, Biljana, Thiery, Guillaume
Format: Article
Language:English
Subjects:
Adult
Bosnia and Herzegovina - epidemiology
Clinical Science
Female
Hospital Mortality
Hospitalization
Humans
Influenza A Virus, H1N1 Subtype - isolation & purification
Influenza, Human - complications
Influenza, Human - epidemiology
Influenza, Human - therapy
Intensive Care Units - statistics & numerical data
Male
Middle Aged
Multiple Organ Failure
Nasopharynx - virology
Respiration, Artificial
Respiratory Distress Syndrome, Adult
Retrospective Studies
Reverse Transcriptase Polymerase Chain Reaction
Serbia - epidemiology
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Summary:To describe characteristics and outcome of mechanically ventilated patients admitted to three newly established intensive care units (ICU) in Bosnia-Herzegovina and Serbia for 2009 H1N1 influenza infection. The retrospective observational study included all mechanically ventilated adult patients of three university-affiliated hospitals between November 1, 2009 and March 1 2010 who had 2009 H1N1 influenza infection confirmed by real-time reverse transcriptase-polymerase-chain-reaction (RT-PCR) from nasopharyngeal swab specimens and respiratory secretions. The study included 50 patients, 31 male (62%), aged 43±13 years. Median time from hospital to ICU admission was 1 day (range 1-2). Sixteen patients (30%) presented with one or more chronic medical condition: 8 (16%) with chronic lung disease, 5 (10%) with chronic heart failure, and 3 (6%) with diabetes mellitus. Thirty-two (64%) were obese. Forty-eight patients (96%) experienced acute respiratory distress syndrome (ARDS), 28 (56%) septic shock, and 27 (54%) multiorgan failure. Forty-five patients (90%) were intubated and mechanically ventilated, 5 received non-invasive mechanical ventilation, 7 (14%) high-frequency oscillatory ventilation, and 7 (14%) renal replacement therapy. The median duration of mechanical ventilation was 7 (4-14) days. Hospital mortality was 52%. Influenza 2009 H1N1 infection in three southeast European ICUs affected predominantly healthy young patients and was associated with rapid deterioration after hospital admission and severe respiratory and multiorgan failure. These emerging ICUs provided contemporary ICU services, resulting in case-fatality rate comparable to reports from well-established ICU settings.
ISSN:0353-9504
1332-8166
DOI:10.3325/cmj.2012.53.620