Original scientific paper
Characteristics and outcome of mechanically ventilated patients with 2009 H1N1 influenza in Bosnia and Herzegovina and Serbia: impact of newly established multidisciplinary intensive care units
Marija Kojičić
; Medical Intensive Care Unit, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica Serbia
Pedja Kovačević
; Medical Intensive Care Unit, Clinical Center University of Banja Luka, Bosnia and Herzegovina
Nermina Bajramović
; Medical Intensive Care Unit, Clinical Center University Sarajevo, Bosnia and Herzegovina
Uroš Batranović
; Medical Intensive Care Unit, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica Serbia
Jadranka Vidović
; Medical Intensive Care Unit, Clinical Center University of Banja Luka, Bosnia and Herzegovina
Kenana Aganović
; Medical Intensive Care Unit, Clinical Center University Sarajevo, Bosnia and Herzegovina
Srdjan Gavrilović
; Medical Intensive Care Unit, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica Serbia
Biljana Zlojutro
; Medical Intensive Care Unit, Clinical Center University of Banja Luka, Bosnia and Herzegovina
Guillaume Thiery
; Medical Intensive Care Unit, Clinical Center University Sarajevo, Bosnia and Herzegovina
Abstract
Aim To describe characteristics and outcome of mechanically
ventilated patients admitted to three newly established
intensive care units (ICU) in Bosnia-Herzegovina and
Serbia for 2009 H1N1 influenza infection.
Methods The retrospective observational study included
all mechanically ventilated adult patients of three university-
affiliated hospitals between November 1, 2009 and
March 1 2010 who had 2009 H1N1 influenza infection
confirmed by real-time reverse transcriptase-polymerasechain-
reaction (RT-PCR) from nasopharyngeal swab specimens
and respiratory secretions.
Results The study included 50 patients, 31 male (62%),
aged 43 ± 13 years. Median time from hospital to ICU admission
was 1 day (range 1-2). Sixteen patients (30%)
presented with one or more chronic medical condition:
8 (16%) with chronic lung disease, 5 (10%) with chronic
heart failure, and 3 (6%) with diabetes mellitus. Thirty-two
(64%) were obese. Forty-eight patients (96%) experienced
acute respiratory distress syndrome (ARDS), 28 (56%) septic
shock, and 27 (54%) multiorgan failure. Forty-five patients
(90%) were intubated and mechanically ventilated,
5 received non-invasive mechanical ventilation, 7 (14%)
high-frequency oscillatory ventilation, and 7 (14%) renal
replacement therapy. The median duration of mechanical
ventilation was 7 (4-14) days. Hospital mortality was 52%.
Conclusion Influenza 2009 H1N1 infection in three southeast
European ICUs affected predominantly healthy young
patients and was associated with rapid deterioration after
hospital admission and severe respiratory and multiorgan
failure. These emerging ICUs provided contemporary ICU
services, resulting in case-fatality rate comparable to reports
from well-established ICU settings.
Keywords
Hrčak ID:
95892
URI
Publication date:
15.12.2012.
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