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H1N1-infected Patients in ICU and Their Clinical Outcome

Talkad Chandrashekar Nagesh Kumar1, Nanjangudu Subramanya Shivakumar, Telugu Sitaram Deepak

  • 1Department of Internal Medicine, MS Ramaiah Medical College and Memorial Hospital, Bangalore, Karnataka, India.

North American Journal of Medical Sciences
|October 11, 2012
PubMed

Insights

This study on H1N1 patients in the ICU found that fever and breathlessness were common symptoms, and acute respiratory distress syndrome (ARDS) led to most deaths. Procalcitonin levels helped predict outcomes in severe cases.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Epidemiology

Background:

  • The 2009 H1N1 influenza pandemic highlighted the need for understanding intensive care unit (ICU) management of severe influenza.
  • Retrospective analysis of H1N1 patients admitted to the ICU provides crucial data for managing novel influenza strains.

Purpose of the Study:

  • To characterize the profile and clinical patterns of H1N1 patients admitted to the ICU.
  • To investigate factors associated with treatment outcomes in H1N1 ICU patients.

Main Methods:

  • Retrospective analysis of demographic, clinical, and laboratory data from 32 RT-PCR confirmed H1N1 cases.
  • Statistical analysis (Fischer's exact test/paired t test) comparing survivors and non-survivors.
  • Data included ICU admission criteria, lung injury type, oxygenation methods, and medications.

Main Results:

  • The majority of cases (78%) were in the 15-45 age group, which also had the highest mortality (60%).
  • Fever and breathlessness were universal symptoms; tachypnea and tachycardia were common signs.
  • 75% developed Acute Respiratory Distress Syndrome (ARDS), with a 16% survival rate; fatal cases often showed elevated procalcitonin (PCT).
  • 25% developed Acute Lung Injury (ALI) and recovered fully.

Conclusions:

  • Fever and breathlessness are key indicators for H1N1 ICU admission.
  • Clinical signs like tachypnea and tachycardia predict respiratory complications.
  • Arterial blood gas (ABG) analysis and PaO2/FiO2 ratio are vital for assessing lung injury severity and ventilation strategy.
  • ARDS is the primary cause of mortality; serum PCT levels are valuable for outcome prediction.
Abstract

Keywords:
Acute lung injuryAcute respiratory distress syndromeArterial blood gas analysisH1N1Intensive care unit

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