Document Detail


Severe influenza A(H1N1)2009 infection: a single centre experience and review of the literature.
MedLine Citation:
PMID:  22480031     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The first influenza pandemic of the 21st century started in April 2009 with an outbreak of swine origin influenza A(H1NI)2009 in Mexico and the United States. While generally a mild disease affecting mostly school-aged children and young adults, most attention went to severe cases of pneumonia in young previously healthy individuals or individuals belonging to a risk group. In this article we review the literature on the presentation and management of severe cases of influenza A(H1N1)2009 in the intensive care unit (ICU), and describe our own experience in a tertiary referral centre with ECMO facilities. Pregnant women and (bone marrow) transplant patients are two known risk groups for severe influenza described more thoroughly in this paper.These severely ill patients are characterized by respiratory failure, resulting often in the need of mechanical ventilation. As Oseltamivir resistance remains low up till now, early antiviral therapy with Oseltamivir is warranted in these cases. Despite pharmacological and ventilator management, refractory hypoxaemia is described frequently in these patients, with need for rescue therapies like nitric oxide inhalation, high frequency ventilation, and extracorporeal membrane oxygenation. The value of the use of corticosteroids is under discussion. Despite advances in management strategies, mortality and morbidity in these severe cases remains high. In the first influenza season after the pandemic, winter 2010/2011, influenza A(H1N1)2009 is the major influenza A strain in Europe, resulting in reports with increased mortality and morbidity compared to pre-pandemic seasonal influenza. "Continuing vigilance for severe influenza in patients not belonging to the classical influenza risk group might still be warranted for the upcoming influenza season".
Authors:
S H van Ierssel; M Leven; P G Jorens
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Acta clinica Belgica     Volume:  67     ISSN:  1784-3286     ISO Abbreviation:  Acta Clin Belg     Publication Date:    2012 Jan-Feb
Date Detail:
Created Date:  2012-04-06     Completed Date:  2012-08-14     Revised Date:  2014-03-18    
Medline Journal Info:
Nlm Unique ID:  0370306     Medline TA:  Acta Clin Belg     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  1-6     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antiviral Agents / therapeutic use
Belgium / epidemiology
Child
Cohort Studies
Extracorporeal Membrane Oxygenation
Female
Humans
Influenza A Virus, H1N1 Subtype*
Influenza, Human / diagnosis*,  epidemiology,  therapy*
Intensive Care*
Male
Middle Aged
Pandemics*
Pregnancy
Pregnancy Complications, Infectious / diagnosis,  epidemiology,  therapy
Chemical
Reg. No./Substance:
0/Antiviral Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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