Pacientes con Gripe por Virus Influenza A (H1N1)pdm09 ingresados en UCI. Impacto de las Recomendaciones de la SEMICYUC

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• dc.contributor.author Marin Corral, Judith
• dc.contributor.author Climent Company, María Cristina
• dc.contributor.author Muñoz Bermudez, Rosana
• dc.contributor.author Samper Echevarria, Maria
• dc.contributor.author Dot Jordana, Irene, 1982-
• dc.contributor.author Vilà Vilardell, Clara
• dc.contributor.author Masclans Enviz, Joan Ramon
• dc.contributor.author Rodríguez, Alejandro
• dc.contributor.author Martín Loeches, Ignacio
• dc.contributor.author Álvarez Lerma, Francisco
• dc.contributor.author H1N1 GETGAG/SEMICYUC Study Group
• dc.date.accessioned 2018-12-12T08:34:03Z
• dc.date.issued 2018
• dc.description.abstract OBJECTIVES: To evaluate the impact of the recommendations of the SEMICYUC (2012) on severe influenza A. DESIGN: A prospective multicenter observational study was carried out. SETTING: ICU. PATIENTS: Patients infected with severe influenza A (H1N1) from the GETGAG/SEMICYUC registry. INTERVENTIONS: Analysis of 2 groups according to the epidemic period of the diagnosis (2009-2011; 2013-2015). VARIABLES: Demographic, temporal, comorbidities, severity, treatments, mortality, late diagnosis and place of acquisition. RESULTS: A total of 2,205 patients were included, 1,337 (60.6%) in the first period and 868 (39.4%) in the second one. Age and severity on admission were significantly greater in the second period, as well as co-infection. With regard to the impact of the recommendations, in the second period the diagnosis was established earlier (70.8 vs. 61.1%, P<.001), without changes in the start of treatment. Patients received less corticosteroid treatment (39.7 vs. 44.9%, P<.05), more NIMV was used (47.4 vs. 33.2%, P<.001) and more vaccination was made (11.1 vs. 1.7%, P<.001), without changes in mortality (24.2 vs. 20.7%). A decrease in nosocomial infection was also noted (9.8 vs. 16%, P<.001). Patients needed less MV with more days of ventilation, more vasopressor drug use and more ventral decubitus. CONCLUSIONS: The management of patients with severe influenza A (H1N1) has changed over the years, though without changes in mortality. The recommendations of the SEMICYUC (2012) have allowed earlier diagnosis and improved corticosteroid use. Pending challenges are the delay in treatment, the vaccination rate and the use of NIMV.
• dc.format.mimetype application/pdf
• dc.identifier.citation Marin-Corral J, Climent C, Muñoz R, Samper M, Dot I, Vilà C. et al. Pacientes con Gripe por Virus Influenza A (H1N1)pdm09 ingresados en UCI. Impacto de las Recomendaciones de la SEMICYUC. Med Intensiva. 2018 Nov;42(8):473-481. DOI: 10.1016/j.medin.2018.02.002
• dc.identifier.doi http://dx.doi.org/10.1016/j.medin.2018.02.002
• dc.identifier.issn 0210-5691
• dc.identifier.uri http://hdl.handle.net/10230/36036
• dc.language.iso spa
• dc.publisher Elsevier
• dc.relation.ispartof Medicina intensiva. 2018 Nov;42(8):473-81
• dc.rights © Elsevier http://dx.doi.org/10.1016/j.medin.2018.02.002
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.subject.keyword Critically illness
• dc.subject.keyword Enfermedad crítica
• dc.subject.keyword Infección por virus influenza A (H1N1)pdm09
• dc.subject.keyword Influenza A (H1N1)pdm09 virus infection
• dc.subject.keyword Intensive Care Unit
• dc.subject.keyword Manejo terapéutico
• dc.subject.keyword Mortalidad
• dc.subject.keyword Mortality
• dc.subject.keyword Outcome
• dc.subject.keyword Pronóstico
• dc.subject.keyword Therapeutic management
• dc.subject.keyword Unidad de Cuidados Intensivos
• dc.subject.other Grip A (H1N1)
• dc.title Pacientes con Gripe por Virus Influenza A (H1N1)pdm09 ingresados en UCI. Impacto de las Recomendaciones de la SEMICYUC
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/acceptedVersion