Valdés SO, Almendro SLA

Language: Spanish
References: 11
Page:
PDF size: 155.32 Kb.

ABSTRACT

Introduction: Influenza A (H1N1) appeared in the world in 2009, inevitably Cuba also suffered the infection. Objective: To know the characteristics of the ventilatory support in patients with presumptive or susceptive infection to Influenza A (H1N1). Method: Through a descriptive, longitudinal, retrospective study we reflect the reality of two Polyvalent Intensive Care Units (PICU) of Havana in the last half of 2009. The study group was represented by 36 patients diagnosed with suspected infection with influenza A (H1N1) and the sample were 17 patients requiring mechanical ventilator support. Results: 61.2% were female patients, with a mean age of 49.1 years. The 47.22% of the hospitalized cases required mechanical artificial ventilation (VAM). Females occupied the highest percentage of ventilated patients (64.7%) with a mean age of 52.5 years. There was a high mortality in ventilated patients with influenza A (H1N1) of 82.35%, showing significant relationship between VAM and fatal outcome in PICU. The 64.3% of deaths occurred in mechanically ventilated women and the most affected age group were between 55 and 64 years (28.6%). There was no statistically significant correlation between the starting of the VAM and mortality in ventilated patients. Survival in ventilated patients was 40% but only for those who remained attached to the respirator for more than 15 days. Conclusions: Patients with a history of COPD, chronic renal failure and liver cirrhosis were the most affected because 100% of those admitted were ventilated and all died. The 28.57% of the pregnant patients admitted to the PICU needed VAM with 50% of maternal lethality.

REFERENCES

1. WHO Guidelines for pharmacological management of Pandemic (H1N1) 2009 influenza and other influenza virus, [serie en Internet]. 2009 Ago [citado 10 Sep 2009]. Disponible en: http://www.who.int/csr/resources/ publications/ swineflu/h1n1_guidelines_pharmaceutical_mngt.pdf.

2. Centers for Disease Control and Prevention (CDC). Updated Interim Recommendations for the Use of Antiviral Medications in the Treatment and Prevention of Influenza for the 2009-2010 Season. [serie en Internet]. 2009 Sep [citado 10 Sep 2009]. Disponible en: http:// www .cdc. gov /h1n1flu /recommendations.htm

3. Reina R, Balasini C. Tratamiento de los pacientes con insuficiencia respiratoria aguda en pandemia por el nuevo virus de la gripe A/H1N1sw1. Revista electrónica de medicina intensiva. [serie en Internet]. 2009 Ago [citado 10 Sep 2009]. Artículo especial 106;9(8). Disponible en: http://remi.uninet.edu.

4. Jamieson DJ, Honein MA, Rasmussen SA. H1N1 2009 influenza virus infection during pregnancy in the USA. 2009. Lancet. 2009;374(9688):451-8.

5. Perez-Padilla R, De la Rosa-Zamboni D, Ponce de Leon S, Hernández M, Quiñónez-Falconi F, Bautista E, et al. Pneumonia and respiratory failure from swine-origen influenza A (H1N1) in Mexico. N Engl J Med. 2009;361:680-9.

6. Puga MS. Factores que influyen en la mortalidad del paciente ventilado en una UCI. Rev Cub Med Int Emerg. 2009;8(2):1490-8.

7. Puga MS, Padrón SA, Peña DR, Bravo PR. Aplicación de un protocolo para la retirada rápida de la ventilación mecánica. Rev Cub Med Milit. 2001;2(Supl.):12-19.

8. Farías JA, Frutos VF, Casado FJ, Siaba A. Factores asociados al pronóstico de los pacientes pediátricos ventilados mecánicamente. Med Intensiva. 2006;30(9):425-31.

9. The Acute Respiratory Distress Syndrome Network: Ventilation with tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000;342:1301.

10. Alfonso Falcón D, Jova Dueñas J, Cortizo Hernández J, Figueredo Fonseca J, Díaz Mesa A. Guía de práctica clínica para el tratamiento de la neumonía Extrahospitalaria grave. Medisur. 2009;7(1):1-6.

11. Jova Dueñas J, Alfonso Falcón D, Iraola Ferrer M, Santana Carballosa J, Marrero JN. Guía de práctica clínica para el tratamiento de la sepsis grave. Medisur. 2009; 7(1):59-64.