Potential pediatric intensive care unit demand/capacity mismatch due to novel pH1N1 in Canada

Stiff, David; Kumar, Anand; Kissoon, Niranjan; Fowler, Robert; Jouvet, Philippe; Skippen, Peter; Smetanin, Paul; Kesselman, Murray; Veroukis, Stasa

doi:10.1097/pcc.0b013e3181e2a4fe

Cited by 21 publications

(11 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study showed that if the attack rate was higher than 15%, significant PICU shortages would be expected to occur. However, this did not occur during the first or second wave -the attack rate was estimated at approximately 10% [51]. There were enough beds and mechanical ventilators in Canadian PICUs to provide critical care despite a 3% increase in admissions.…”

Section: Disease Burden On Healthcare Resourcesmentioning

confidence: 91%

“…Some studies performed using data from the first wave suggested a possible mismatch between resources (e.g., ventilators and PICU beds) and care demands [50,51]. To improve forecasting, it will be necessary to improve real-time data collection and further delineate geography-and population-specific risks.…”

Section: Adaptation Of Health Resources To Pandemic Burdenmentioning

confidence: 97%

See 1 more Smart Citation

H1N1 pandemic: clinical and epidemiologic characteristics of the Canadian pediatric outbreak

Fléchelles

Fowler

Jouvet

2013

Expert Review of Anti-infective Therapy

Self Cite

View full text Add to dashboard Cite

Canada was one of the first countries affected by the 2009 influenza H1N1 pandemic with two waves - one from May to June and one from October to December. The 2009 influenza H1N1 pandemic had many unique features when compared with seasonal influenza, including the following: more than half of the affected people were children; asthma was the most significant risk factor for hospital admission; and Aboriginal and pregnant women had a higher risk of hospital admission and complications. Antiviral therapy was widely used but data did not show any effect on the pediatric population. Outbreak spread was possibly promoted from child-child and child-adult contact, and therefore the vaccination campaign targeted the pediatric population and achieved good coverage among young children (57%). Vaccination efficacy was difficult to test because of the vaccination delay. Improvement in models of prevention and treatment are urgently needed to prepare for the possible future pandemics.

show abstract

Section: Disease Burden On Healthcare Resourcesmentioning

confidence: 91%

Section: Adaptation Of Health Resources To Pandemic Burdenmentioning

confidence: 97%

H1N1 pandemic: clinical and epidemiologic characteristics of the Canadian pediatric outbreak

Fléchelles

Fowler

Jouvet

2013

Expert Review of Anti-infective Therapy

Self Cite

View full text Add to dashboard Cite

show abstract

“…Family practitioners provide primary health care in each country and most vaccine delivery does not require out-of-pocket payment. The number of PICU is also similar (2.9 bed/100000 children under 15 years in Canada and 2.5 beds per 100000 children in France)[9,13]. During the pandemic, treatment recommendations were the same, those of the World Health Organization.…”

Section: Methodsmentioning

confidence: 99%

Pandemic influenza 2009: Impact of vaccination coverage on critical illness in children, a Canada and France observational study

Fléchelles

Brissaud

Fowler

et al. 2016

WJCP

Self Cite

View full text Add to dashboard Cite

AIMTo study the impact of vaccination critical illness due to H1N1pdm09, we compared the incidence and severity of H1N1pdm09 infection in Canada and France.METHODSWe studied two national cohorts that included children with documented H1N1pdm09 infection, admitted to a pediatric intensive care unit (PICU) in Canada and in France between October 1, 2009 and January 31, 2010.RESULTSVaccination coverage prior to admission to PICUs was higher in Canada than in France (21% vs 2% of children respectively, P < 0.001), and in both countries, vaccination coverage prior to admission of these critically ill patients was substantially lower than in the general pediatric population (P < 0.001). In Canada, 160 children (incidence = 2.6/100000 children) were hospitalized in PICU compared to 125 children (incidence = 1.1/100000) in France (P < 0.001). Mortality rates were similar in Canada and France (4.4% vs 6.5%, P = 0.45, respectively), median invasive mechanical ventilation duration and mean PICU length of stay were shorter in Canada (4 d vs 6 d, P = 0.02 and 5.7 d vs 8.2 d, P = 0.03, respectively). H1N1pdm09 vaccination prior to PICU admission was associated with a decreased risk of requiring invasive mechanical ventilation (OR = 0.30, 95%CI: 0.11-0.83, P = 0.02).CONCLUSIONThe critical illness due to H1N1pdm09 had a higher incidence in Canada than in France. Critically ill children were less likely to have received vaccination prior to hospitalization in comparison to general population and children vaccinated had lower risk of ventilation.

show abstract

“…This approach may serve as a resource multiplier and may allow CSC to be instituted for shorter periods of time. Furthermore, in certain pandemics, younger children may be more vulnerable to respiratory failure and modeling for the younger age, and varying duration of infection and vaccination rates will be needed depending on the infectious agent to determine when CSC should be instituted (13). The outcome predictors model is not perfect.…”

mentioning

confidence: 96%

Allocation of Resources During Crisis

Kissoon

Skippen

2015

Pediatric Critical Care Medicine

Self Cite

View full text Add to dashboard Cite

Potential pediatric intensive care unit demand/capacity mismatch due to novel pH1N1 in Canada

Abstract: Reducing the attack rate among children, whether through vaccination or additional measures, such as social distancing, will be critical to ensure sufficient pediatric intensive care unit capacity for continued pediatric care.

Cited by 21 publications

References 17 publications

H1N1 pandemic: clinical and epidemiologic characteristics of the Canadian pediatric outbreak

H1N1 pandemic: clinical and epidemiologic characteristics of the Canadian pediatric outbreak

Pandemic influenza 2009: Impact of vaccination coverage on critical illness in children, a Canada and France observational study

Allocation of Resources During Crisis

Contact Info

Product

Resources

About