Influenza A (H1N1pdm09)-Related Critical Illness and Mortality in Mexico and Canada, 2014*

作者：Guillermo Domínguez‐Cherit, Alethse de la Torre, Asgar H. Rishu, Ruxandra L Pinto, Silvio Antonio Ñamendys-Silva, Adrián Camacho-Ortíz, Marco Antonio Silva-Medina, Carmen Margarita Hernández‐Cardenas, Michel Martínez‐Franco, Alejandro Quesada-Sánchez, Guadalupe Celia López-Gallegos, Juan Luis Mosqueda-Gómez, Norma Eréndira Rivera-Martínez, Fernando Campos-Calderón, Eduardo Rivero-Sigarroa, Thierry Hernández‐Gilsoul, Lourdes Espinosa-Pérez, Alejandro Ernesto Macías, Dolores M. Lue-Martínez, Christian Buelna-Cano, Ana Sofia Ramirez Garcia Luna, Néstor G Cruz-Ruiz, Manuel Poblano-Morales, Fernando Molinar-Ramos, Martín Hernández-Torre, Marco Antonio León-Gutiérrez, Oscar Rosaldo-Abundis, José Ángel Baltazar-Torres, Henry T. Stelfox, Bruce Light, Philippe A. Jouvet, Steve Reynolds, Richard Hall, Nikki Shindo, Nick Daneman, Robert Fowler · 发表于：Critical Care Medicine · 年份：2016 · DOI：10.1097/ccm.0000000000001830 · 被引用次数：30 · 研究领域：Influenza Virus Research Studies、Respiratory viral infections research、Thermal Regulation in Medicine

OBJECTIVES: The 2009-2010 influenza A (H1N1pdm09) pandemic caused substantial morbidity and mortality among young patients; however, mortality estimates have been confounded by regional differences in eligibility criteria and inclusion of selected populations. In 2013-2014, H1N1pdm09 became North America's dominant seasonal influenza strain. Our objective was to compare the baseline characteristics, resources, and treatments with outcomes among critically ill patients with influenza A (H1N1pdm09) in Mexican and Canadian hospitals in 2014 using consistent eligibility criteria. DESIGN: Observational study and a survey of available healthcare setting resources. SETTING: Twenty-one hospitals, 13 in Mexico and eight in Canada. PATIENTS: Critically ill patients with confirmed H1N1pdm09 during 2013-2014 influenza season. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The main outcome measures were 90-day mortality and independent predictors of mortality. Among 165 adult patients with H1N1pdm09-related critical illness between September 2013 and March 2014, mean age was 48.3 years, 64% were males, and nearly all influenza was community acquired. Patients were severely hypoxic (median PaO2-to-FIO2 ratio, 83 mm Hg), 97% received mechanical ventilation, with mean positive end-expiratory pressure of 14 cm H2O at the onset of critical illness and 26.7% received rescue oxygenation therapy with prone ventilation, extracorporeal life support, high-frequency oscillatory ventilation, or i...