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Long-term outcomes of pandemic 2009 influenza A (H1N1)-associated severe acute respiratory distress syndrome.
MedLine Citation:
PMID:  22362874     Owner:  NLM     Status:  Publisher    
ABSTRACT BACKGROUND:No data on long-term outcomes of survivors of 2009 influenza A (H1N1) (2009-H1N1)-associated ARDS are available. To compare the 1-year outcomes of survivors of 2009-H1N1-associated acute respiratory distress syndrome (ARDS), according to extracorporeal lung assist (ECLA) use or not, using its need as an ARDS-severity surrogate. METHODS:ARDS survivors (12 with ECLA vs. 25 without, corresponding to 75% and 54% of the eligible patients for each group, respectively), selected from the French registry of critically ill, 2009-H1N1-infected patients, had previously been healthy with only pregnancy and/or moderate obesity (BMI≤35 kg/m(2)) as known risk factors for 2009-H1N1 infection. Lung function and morphology, health-related quality of life (HRQoL) and psychological impairment were evaluated. RESULTS:At 1-year post-ICU discharge, for ECLA and no-ECLA groups, respectively, 50% and 40% reported significant exertion dyspnea, 83% and 64% had returned to work, 75% and 64% had decreased diffusion capacity across the blood-gas barrier, despite their near-normal and similar lung-function-test results. For both groups, exercise-test results showed diminished but comparable exercise capacities, with similar alveolar-arterial O(2) gradients at peak exercise, and CT-scan showed minor abnormal findings. SF-36-assessed HRQoL was poorer for both groups than a sex- and age-matched general population, but without between-group differences. ECLA and no-ECLA patients, respectively, had symptoms of anxiety (50% and 56%) and depression (28% and 28%), and were at risk for post-traumatic stress disorder (41% and 44%). CONCLUSIONS:One-year post-ICU discharge, a majority of 2009-H1N1-associated ARDS survivors had minor lung disabilities with diminished diffusion capacities across the blood-gas barrier, and most had psychological impairment and poorer HRQoL than sex- and age-matched general population. ECLA and no-ECLA patients had comparable outcomes.
Charles-Edouard Luyt; Alain Combes; Marie-Hélène Becquemin; Catherine Beigelman-Aubry; Stéphane Hatem; Anne-Laure Brun; Nizar Zraik; Fabrice Carrat; Philippe A Grenier; Jean-Christophe M Richard; Alain Mercat; Laurent Brochard; Christian Brun-Buisson; Jean Chastre;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-23
Journal Detail:
Title:  Chest     Volume:  -     ISSN:  1931-3543     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1Service de Réanimation Médicale.
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