Featured Research

from universities, journals, and other organizations

H1N1 Critical Illness Can Occur Rapidly; Predominantly Affects Young Patients

Date:
October 13, 2009
Source:
JAMA and Archives Journals
Summary:
Critical illness among Canadian patients with 2009 influenza A (H1N1) occurred rapidly after hospital admission, often in young adults, and was associated with severely low levels of oxygen in the blood, multi-system organ failure, a need for prolonged mechanical ventilation and frequent use of rescue therapies, according to a new study.

Critical illness among Canadian patients with 2009 influenza A(H1N1) occurred rapidly after hospital admission, often in young adults, and was associated with severely low levels of oxygen in the blood, multi-system organ failure, a need for prolonged mechanical ventilation, and frequent use of rescue therapies, according to a new study.

Related Articles


Infection with the 2009 influenza A(H1N1) virus has been reported in virtually every country in the world. The World Health Organization declared the first phase six (phase indicating widespread human infection) global influenza pandemic of the century on June 11, 2009. The largest number of confirmed cases occurred in North America between March and July 2009, according to background information in the article.

Anand Kumar, M.D., of the Health Sciences Centre and St. Boniface Hospital, Winnipeg, Manitoba, Canada, and colleagues with the Canadian Critical Care Trials Group H1N1 Collaborative conducted an observational study of critically ill patients with 2009 influenza A(H1N1) in 38 adult and pediatric intensive care units (ICUs) in Canada between April 16 and August 12, 2009. The study focused on the death rate at 28 and 90 days, as well as the frequency and duration of mechanical ventilation and the duration of ICU stay.

The researchers found that a total of 168 patients had confirmed or probable 2009 influenza A(H1N1) infection and became critically ill during this time period, and 24 (14.3 percent) died within the first 28 days from the onset of critical illness. Five more patients died within 90 days. The average age of the patients with confirmed or probable 2009 influenza A(H1N1) was 32.3 years, 113 were female (67.3 percent), and 50 were children (29.8 percent).

"Our data suggest that severe disease and mortality in the current outbreak is concentrated in relatively healthy adolescents and adults between the ages of 10 and 60 years, a pattern reminiscent of the W-shaped curve [rise and fall in the population mortality rate for the disease, corresponding to age at death] previously seen only during the 1918 H1N1 Spanish pandemic," the authors write.

Patients with 2009 influenza A(H1N1) infection-related critical illness experienced symptoms for a median (midpoint) of four days before entering the hospital, but worsened rapidly and required care in the ICU within one or two days. Shock and multi-system organ failure were common, and 136 patients (81 percent) received mechanical ventilation, with the median duration being 12 days. The average ICU stay was 12 days. Lung rescue therapies included neuromuscular blockade, inhaled nitric oxide and high-frequency oscillatory ventilation.

"In conclusion, we have demonstrated that 2009 influenza A(H1N1) infection-related critical illness predominantly affects young patients with few major comorbidities and is associated with severe hypoxemic respiratory failure, often requiring prolonged mechanical ventilation and rescue therapies," the authors write. "With such therapy, we found that most patients can be supported through their critical illness."

Editorial: Preparing for the Sickest Patients With 2009 Influenza A(H1N1)

In an accompanying editorial, Douglas B. White, M.D., M.A.S., and JAMA Contributing Editor Derek C. Angus, M.D., M.P.H., of the University of Pittsburgh School of Medicine, write that many U.S. hospitals may not have adequate numbers of physicians or staffing structures to facilitate timely treatment of the most seriously ill patients with 2009 influenza A(H1N1).

"Hospitals must develop explicit policies to equitably determine who will and will not receive life support should absolute scarcity occur," they write. "Any deaths from 2009 influenza A(H1N1) will be regrettable, but those that result from insufficient planning and inadequate preparation will be especially tragic," they conclude.


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Anand Kumar; Ryan Zarychanski; Ruxandra Pinto; Deborah J. Cook; John Marshall; Jacques Lacroix; Tom Stelfox; Sean Bagshaw; Karen Choong; Francois Lamontagne; Alexis F. Turgeon; Stephen Lapinsky; Stephane P. Ahern; Orla Smith; Faisal Siddiqui; Philippe Jouvet; Kosar Khwaja; Lauralyn McIntyre; Kusum Menon; Jamie Hutchison; David Hornstein; Ari Joffe; Francois Lauzier; Jeffrey Singh; Tim Karachi; Kim Wiebe; Kendiss Olafson; Clare Ramsey; Satendra Sharma; Peter Dodek; Maureen Meade; Richard Hall; Robert Fowler; for the Canadian Critical Care Trials Group H1N1 Collaborative. Critically Ill Patients With 2009 Influenza A(H1N1) Infection in Canada. JAMA, 2009;0(2009):2009.1496 DOI: 10.1001/jama.2009.1496

Cite This Page:

JAMA and Archives Journals. "H1N1 Critical Illness Can Occur Rapidly; Predominantly Affects Young Patients." ScienceDaily. ScienceDaily, 13 October 2009. <www.sciencedaily.com/releases/2009/10/091012121335.htm>.
JAMA and Archives Journals. (2009, October 13). H1N1 Critical Illness Can Occur Rapidly; Predominantly Affects Young Patients. ScienceDaily. Retrieved March 31, 2015 from www.sciencedaily.com/releases/2009/10/091012121335.htm
JAMA and Archives Journals. "H1N1 Critical Illness Can Occur Rapidly; Predominantly Affects Young Patients." ScienceDaily. www.sciencedaily.com/releases/2009/10/091012121335.htm (accessed March 31, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Tuesday, March 31, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Solitair Device Aims to Takes Guesswork out of Sun Safety

Solitair Device Aims to Takes Guesswork out of Sun Safety

Reuters - Innovations Video Online (Mar. 31, 2015) — The Solitair device aims to take the confusion out of how much sunlight we should expose our skin to. Small enough to be worn as a tie or hair clip, it monitors the user&apos;s sun exposure by taking into account their skin pigment, location and schedule. Matthew Stock reports. Video provided by Reuters
Powered by NewsLook.com
Soda, Salt and Sugar: The Next Generation of Taxes

Soda, Salt and Sugar: The Next Generation of Taxes

Washington Post (Mar. 30, 2015) — Denisa Livingston, a health advocate for the Dinι Community Advocacy Alliance, and the Post&apos;s Abby Phillip discuss efforts around the country to make unhealthy food choices hurt your wallet as much as your waistline. Video provided by Washington Post
Powered by NewsLook.com
UnitedHealth Buys Catamaran

UnitedHealth Buys Catamaran

Reuters - Business Video Online (Mar. 30, 2015) — The $12.8 billion merger will combine the U.S.&apos; third and fourth largest pharmacy benefit managers. Analysts say smaller PBMs could also merge. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com
S. Leone in New Anti-Ebola Lockdown

S. Leone in New Anti-Ebola Lockdown

AFP (Mar. 28, 2015) — Sierra Leone imposed a three-day nationwide lockdown Friday for the second time in six months in a bid to prevent a resurgence of the deadly Ebola virus. Duration: 01:17 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins