Læknablaðið - 15.02.2010, Blaðsíða 18

FRÆÐIGREINAR
RANNSÓKNIR
Intensive care patients with influenza A (H1N1) infection in lceland 2009
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Background: We describe the main characteristics of
patients that required intensive care due to the influenza
(H1N1) outbrake in 2009.
Methods: Retrospective and prospective analysis of
medical records from patients admitted to ICU with
positive RT-PCR for (H1N1).
Results: During a six week period in the fall of 2009, 16
patients were admitted to intensive care in lceland with
confirmed H1N1 infection. Mean age was 48 years (range
1-81). Most patients were considered quite healthy but
the majority had risk factors such as smoking, obesity
or hypertension. All but one had fever, cough, dyspnea
and bilateral infiltrates on chest x-ray and developed any
organ failures (mean SOFA score 7). 12 needed mechanical
ventilation and two extra corporeal membrane oxygenation
(ECMO). Mean APACHE II score was 20. No patient died
in the ICU but one elderly patient with multiple underlying
diseases died a few days after being discharged from the
ICU.
Conclusions: (1) The incidence of severe influenza A
(H1N1) that leads to ICU admission appears to be high
in lceland. (2) Many patients developed acute respiratory
distress syndrome in addition to other organ failures,
and required additional measures for oxygenation such
as prone position, nitric oxide inhalation and ECMO. (3)
28 day mortality was low. (4) This study will aid in future
outbreak planning in lceland.
Sigurdsson GH, MöllerAD, Kristinsson B, Gudlaugsson O, Karason S, Sigurdsson SE, Kristjansson M, Sigvaldason K.
Intensive care patients with influenza A (H1N1) infection in lceland 2009. Icel Med J 2010; 83-90
Key words: influenza A, pneumonia, multiple organ failure, death rate, intensive care, ventilator therapy, ECMO.
Correspondence: Gísli H. Sigurðsson, gislihs@landspitali.is
Barst: 4. desember 2009, - samþykkt til birtingar: 14. janúar 2010
Hagsmunatengsl höfunda: Engin
90 LÆKNAblaðið 2010/96