Poster Presentations: Wednesday, November 3, 2010 |

Clinical Presentation of Patients With 2009 Influenza A (H1N1) Virus Admitted to the Medical Intensive Care Unit vs Ambulatory-Treated Patients FREE TO VIEW

Gabriel D. Patarroyo; Maria M. Patarroyo; Adriana C. Prada; Cesar A. Simbaqueba; Oscar O. Sanabria
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Major Universitary Hospital, Bogota, Colombia

Chest. 2010;138(4_MeetingAbstracts):603A. doi:10.1378/chest.9518
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PURPOSE: Our aim is to describe the principal characteristics of the patients admitted to the Intensive Care Unit that tested positive for 2009 Influenza A(H1N1) virus infection compared with patients that didn't required admission.

METHODS: We reviewed the clinical characteristics at admission to the emergency department of all patients that consulted to the emergency department in three different Level III hospitals, with upper respiratory symptoms and that tested positive for 2009 Influenza A(H1N1).

RESULTS: In our cohort of 43 patients with confirmed diagnosis of 2009 Influenza A(H1N1), 12 patients were admitted to the ICU (50% men, 8.3% children), compared with patients that didn't required admission to ICU, these patients were older (mean age 46.4± 22 vs 23.8± 13; p=0,00090),with more comorbidites like: history of smoking (58.33% vs 6.67%; p=0,0002), history of COPD 58% vs 16% p=0.005 and history of Hypertension 25% vs 0% p=0,003. At the time of admission these patients were more tachypneic (RR 28± 7 vs 20± 2 per min; p<0.001), more tachycardic (HR 121± 20 vs 97± 20 beats per min, p=0,0004), more hypoxemic (SpO2 56.8± 12% vs 90± 2%; p<0.0001), with higher temperature (38.5± 0.9 Vs 38.2± 0.6°C; p=0,005), with renal failure (Sr Creatinine 2.6± 1.1 vs 1± 0.19 mg/dl; p<0.0001) and with lower platelets count 341± 108x 103 vs 270± 82x103, with diagnosis of respiratory failure as cause of admission to the ICU in all cases. Finally the treatment with neuraminidase inhibitors in the ICU patients was started later (6.7± 4.1 vs 4.4± 4.2; p=0,025).

CONCLUSION: Patients with 2009 Influenza A(H1N1) with previous history of pulmonary disease and with signs of inflammatory response at admission have a higher incidence of complications and increased risk of death However, this study is limited and the sample size limited this conclusions.

CLINICAL IMPLICATIONS: A higher index of suspicion for influenza A(H1N1) is warranted in patients with upper respiratory infection symptoms with associated systemic inflammatory response.

DISCLOSURE: Gabriel Patarroyo, No Financial Disclosure Information; No Product/Research Disclosure Information

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