Pandemic (H1N1) 2009 influenza: Experience from a critical care unit in India

Sahoo, Jyoti Narayan; Poddar, Banani; Azim, Afzal; Singh, Rekha; Gurjar, Mohan; Baronia, Arvind Kumar

doi:10.4103/0972-5229.74177

Cited by 4 publications

(3 citation statements)

References 6 publications

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“…[ 38 ] In a retrospective study of 7 H1N1 patients in ICU, Sahoo et al . [ 39 ] reported no mortality. Our study included, all the patients admitted to the H1N1 unit irrespective of disease severity.…”

Section: Discussionmentioning

confidence: 99%

Predictors of mortality and length of stay in hospitalized cases of 2009 influenza A (H1N1): Experiences of a tertiary care center

Chawla

Kansal

Chauhan

et al. 2013

Indian Journal of Critical Care Medicine

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Aim:To study the clinical characteristics and outcome of admitted patients of H1N1 (hemagglutinin -H neuraminidase -N) influenza in a tertiary level hospital, from Oct 2009 to Dec 2010.Materials and Methods:A retrospective analysis of 77 confirmed patients admitted in this unit with H1N1 infection.Results:Of the 77 patients studied, 33 (42.8%) were female. Mean age was 40.88 ± 13.45 years, majority (70.13%) being less than 50 years. Thirty eight (49.3%) patients had at least one co-morbidity, diabetes mellitus being the most common (n = 15, 19.5%). The most common presenting symptom was fever in 75 (97.4%) patients, cough in 67 (87%) and dyspnoea in 59 (76.6%) patients. At admission, mean PaO2/FiO2 ratio was 213.16 ± 132.75 mmHg (n = 60) while mean PaCO2 was 40.14 ± 14.86 mmHg. One or more organ failure was present in 45 (58.4%) patients. Nineteen (24.60%) patients required invasive mechanical ventilation. Circulatory failure was observed in 10 (13%) patients while 2 patients required hemodialysis. Overall, 13% mortality (n = 10) was observed. PaCO2 level at admission (OR 1.093; 95% confidence interval: 1.002-1.193; P = 0.044) and number of organ failure (OR 8.089; 95% confidence interval: 1.133-57.778; P = 0.037) were identified as independent risk- factors for mortality.Conclusion:Increased duration of dyspnoea prior to admission, pneumonia, low PaO2/FiO2 ratio at admission and 24 hours later, higher PaCO2 values on admission, higher O2 requirement, number of organ failures and use of corticosteroids and delay in specialized treatment were associated with a poorer outcome.

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Section: Discussionmentioning

confidence: 99%

Predictors of mortality and length of stay in hospitalized cases of 2009 influenza A (H1N1): Experiences of a tertiary care center

Chawla

Kansal

Chauhan

et al. 2013

Indian Journal of Critical Care Medicine

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“…[ 16 ] Sahoo et al . [ 17 ] in their study shown that out of seven patients, five patients had MODS. The commonest organ involved was renal.…”

Section: Discussionmentioning

confidence: 99%

Prone position and pressure control inverse ratio ventilation in H1N1 patients with severe acute respiratory distress syndrome

Venkategowda

Rao

Harde

et al. 2016

Indian Journal of Critical Care Medicine

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Aim:To observe the 28 and 90 days mortality associated with prone position and assist control-pressure control (with inverse ratio) ventilation (ACPC-IRV).Materials and Methods:All patients who were admitted to our medical Intensive Care Unit (ICU) who are positive for H1N1 viral infection with severe acute respiratory distress syndrome (ARDS) and requiring invasive mechanical ventilation in prone position were included in our prospective observational study. Six patients who are positive for H1N1 required invasive ventilation in prone position. These patients were planned to ventilate in prone for 16 h and in supine for 8 h daily until P/F ratio >150 with FiO2 of 0.6 or less and positive end-expiratory pressure <10 cm of H2 O.Results:At admission, among these six patients the mean tidal volume generated was about 376.6 ml which was in the range of 6–8 ml/kg predicted body weight. The mean lung injury score was 3.79, mean PaO2 /FiO2 ratio was 52.66 and mean oxygenation index was 29.83. The mean duration of ventilation was 9.4 days (225.6 h). The ICU length of stay was 11.16 days. There was no mortality at 28 and 90 days.Conclusion:Early prone combined with ACPC-IRV in H1N1 patients having severe ARDS can be used as a rescue therapy and it should be confirmed by large observational studies.

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“…Though observational cohort studies started to be published from North America, Europe, and Australia from 2009, there were only a few case reports published from Indian hospitals. [ 3 4 ]…”

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confidence: 99%