Pacientes con gripe por el virus influenza A (H1N1)pdm09 ingresados en la UCI. Impacto de las recomendaciones de la SEMICYUC

Marín‐Corral, Judith; Climent, Cristina; Muñoz, Ruth Padilla; Samper, M.; Dot, Irene; Vilà, C.; Masclans, Joan-Ramon; Rodríguez, Alejandro; Martín‐Loeches, Ignacio; Álvarez-Lerma, Francisco

doi:10.1016/j.medin.2018.02.002

Cited by 22 publications

(3 citation statements)

References 39 publications

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“…Ventilation in the prone position in cases of moderate-to-severe ARDS is associated with reduced mortality and is currently recommended [16]. This maneuver was used in as high as 21% of mechanically ventilated influenza patients in our study and a similar rate was reported by other researchers [2,17,18]. Extracorporeal therapies provide substantial support to gas exchange in native lungs, thus facilitating protective lung ventilation and reducing the risk of ventilator-induced lung injury.…”

Section: Discussionsupporting

confidence: 81%

“…Influenza is known to predispose the host to secondary bacterial, viral or fungal infections [21][22][23]. In a multicenter study in Spain the rate of bacterial coinfections was reported to be 15 to 21% in influenza patients admitted to the ICU [17] and coinfections were evident in 55.6% of ICU-admitted patients in a study by Beumer et al from the Netherlands [2]. Bacterial coinfection is also known to occur in 30 to 50% of adults with viral community-acquired pneumonia (CAP) [24].…”

Section: Discussionmentioning

confidence: 99%

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Influenza in patients with respiratory failure admitted to intensive care units in Poland and the use of extracorporeal respiratory support: a survey-based multicenter study

et al. 2021

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Background In Poland, little is known about the most serious cases of influenza that need admittance to the intensive care unit (ICU), as well as the use of extracorporeal respiratory support. Methods This was an electronic survey comprising ICUs in two administrative regions of Poland. The aim of the study was to determine the number of influenza patients with respiratory failure admitted to the ICU in the autumn–winter season of 2018/2019. Furthermore, respiratory support, outcome and other pathogens detected in the airways were investigated. Results Influenza infection was confirmed in 76 patients. The A(H1N1)pdm09 strain was the most common. 34 patients died (44.7%). The median age was 62 years, the median sequential organ failure assessment (SOFA) score was 11 and was higher in patients who died (12 vs. 10, p = 0.017). Mechanical ventilation was used in 75 patients and high flow nasal oxygen therapy in 1 patient. Extracorporeal membrane oxygenation (ECMO) was used in 7 patients (6 survived), and extracorporeal carbon dioxide removal (ECCO2R) in 2 (1 survived). The prone position was used in 16 patients. In addition, other pathogens were detected in the airways on admittance to the ICU. Conclusion A substantial number of influenza infections occurred in the autumn–winter season of 2018/2019 that required costly treatment in the intensive care units. Upon admission to the ICU, influenza patients had a high degree of organ failure as assessed by the SOFA score, and the mortality rate was 44.7%. Advanced extracorporeal respiratory techniques offer real survival opportunities to patients with severe influenza-related ARDS. The presence of coinfection should be considered in patients with influenza and respiratory failure.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Influenza in patients with respiratory failure admitted to intensive care units in Poland and the use of extracorporeal respiratory support: a survey-based multicenter study

et al. 2021

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“…Costs for vaccines were €7.50 for QIVc and €6.00 for QIVe. a The resource unit costs were taken from official Spanish sources with the cost of a primary care physician visits at €53.75, 27 an emergency department visit at €285.75, [28][29][30][31] and an inpatient hospitalization, which included an intensive care unit stay for nine days for 7.5% of admissions, at €4,369.66. Patients with symptomatic disease who did not attend a primary care physician visit, emergency department visits, or have an inpatient hospitalization were conservatively assumed to have no public payer or societal costs.…”

Section: Costsmentioning

confidence: 99%

Estimated cost-effectiveness and burden of disease associated with quadrivalent cell-based and egg-based influenza vaccines in Spain

Ruiz-Aragón

Gani

Márquez

et al. 2020

Human Vaccines & Immunotherapeutics

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Influenza is a viral respiratory disease that causes significant clinical and economic burden globally. Quadrivalent influenza vaccine (QIV) is frequently used to protect people who have a high-risk of developing influenza complications due to comorbidities. QIV offers protection against influenza A (A/ H1N1 and H3N2) and B (B/Victoria, and B/Yamagata) strains. The European Medicines Agency has recently approved a cell-based QIV (QIVc) in people aged over 9 years old. QIVc has been shown to be more effective at preventing influenza than traditional egg-based QIV (QIVe). In this study, we use a health economic model adapted to Spain to assess the costs and outcomes associated with using QIVc instead of QIVe in people aged 9-64 at high-risk of complications. Observed vaccine coverage of 32% in the 9-17 age group, 17% in those aged 18-59, and 22% for ages 60-64 was used in the analysis. In total, 2.5 million people were vaccinated in the simulations. Using QIVc instead of QIVe was associated with 16,221fewer symptomatic cases, 4,522 fewer primary care visits, 1,015 fewer emergency room visits and 88 fewer hospitalizations. From a societal perspective, QIVc was more effective and less expensive compared to QIVe, leading to a cost-saving of €3.4 million. From a public payer perspective, the incremental cost-effectiveness ratio for QIVc vs QIVe was €12,852 per QALY gained. In conclusion, QIVc offers a cost-effective alternative to QIVe and should be considered as an alternative vaccine to QIVe for people aged 9-64 at high-risk of influenza complications in Spain.

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Viral Infections in the ICU

Rommes¹,

Saene

Cal

2021

Selective Decontamination of the Digestive Tract (SDD)

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Pacientes con gripe por el virus influenza A (H1N1)pdm09 ingresados en la UCI. Impacto de las recomendaciones de la SEMICYUC

Cited by 22 publications

References 39 publications

Influenza in patients with respiratory failure admitted to intensive care units in Poland and the use of extracorporeal respiratory support: a survey-based multicenter study

Influenza in patients with respiratory failure admitted to intensive care units in Poland and the use of extracorporeal respiratory support: a survey-based multicenter study

Estimated cost-effectiveness and burden of disease associated with quadrivalent cell-based and egg-based influenza vaccines in Spain

Viral Infections in the ICU

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