Critical Care Services and 2009 H1N1 Influenza in Australia and New Zealand.
Critical Care Services and 2009 H1N1 Influenza in Australia and New Zealand.
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DOI：
10.1056/nejmoa0908481
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发表时间：
2009-11-12
影响因子：
158.5
通讯作者：
Yung, Michael
中科院分区：
文献类型：
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作者：
Webb, Steven A. R.;Pettila, Ville;Yung, Michael
背景资料：规划的治疗与2009年大流行性流感A（H1N1）病毒的感染，通过卫生保健系统在发达国家在冬季在北方半球是阻碍了缺乏类似的卫生保健systems.Methods的信息：我们进行了一个inception-cohort研究在所有澳大利亚和新西兰重症监护病房（ICU）在2009年冬季在南半球。我们计算了每百万居民中因感染2009年H1N1病毒而入住ICU的人数、卧床天数和机械通气天数。我们收集了患者的人口统计学和临床特征以及治疗和结局的数据。结果：从2009年6月1日至8月31日，共有722名患者确诊感染2009年H1N1病毒（每百万居民28.7例; 95%置信区间[CI]，26.5至30.8）在澳大利亚或新西兰入住ICU。在722名患者中，669名（92.7%）年龄在65岁以下，66名（9.1%）为孕妇;在601名有数据的成年人中，172名（28.6%）的体重指数（体重（千克）除以身高（米）的平方）大于35。感染2009年H1N1病毒的患者在重症监护病房的总住院日为8815个（每百万居民350个）。ICU治疗的中位持续时间为7.0天（四分位距，2.7 - 13.4）; 706例患者中有456例（64.6%）接受了机械通气，中位持续时间为8天（四分位距，4 - 16）。ICU的最大日占用率为每百万居民7.4张床位（95%CI，6.3 - 8.5）。截至2009年9月7日，722例患者中共有103例（14.3%; 95%CI，11.7至16.9）死亡，114例（15.8%）仍在hospital.Conclusions：2009年H1N1病毒在澳大利亚和新西兰的冬季对ICU产生了重大影响。我们的数据可以帮助制定北方半球冬季患者的治疗计划。N Engl J Med 2009;361：1925-34。
Background: Planning for the treatment of infection with the 2009 pandemic influenza A (H1N1) virus through health care systems in developed countries during winter in the Northern Hemisphere is hampered by a lack of information from similar health care systems.Methods: We conducted an inception-cohort study in all Australian and New Zealand intensive care units (ICUs) during the winter of 2009 in the Southern Hemisphere. We calculated, per million inhabitants, the numbers of ICU admissions, bed-days, and days of mechanical ventilation due to infection with the 2009 H1N1 virus. We collected data on demographic and clinical characteristics of the patients and on treatments and outcomes.Results: From June 1 through August 31, 2009, a total of 722 patients with confirmed infection with the 2009 H1N1 virus (28.7 cases per million inhabitants; 95% confidence interval [CI], 26.5 to 30.8) were admitted to an ICU in Australia or New Zealand. Of the 722 patients, 669 (92.7%) were under 65 years of age and 66 (9.1%) were pregnant women; of the 601 adults for whom data were available, 172 (28.6%) had a body-mass index (the weight in kilograms divided by the square of the height in meters) greater than 35. Patients infected with the 2009 H1N1 virus were in the ICU for a total of 8815 bed-days (350 per million inhabitants). The median duration of treatment in the ICU was 7.0 days (interquartile range, 2.7 to 13.4); 456 of 706 patients (64.6%) with available data underwent mechanical ventilation for a median of 8 days (interquartile range, 4 to 16). The maximum daily occupancy of the ICU was 7.4 beds (95% CI, 6.3 to 8.5) per million inhabitants. As of September 7, 2009, a total of 103 of the 722 patients (14.3%; 95% CI, 11.7 to 16.9) had died, and 114 (15.8%) remained in the hospital.Conclusions: The 2009 H1N1 virus had a substantial effect on ICUs during the winter in Australia and New Zealand. Our data can assist planning for the treatment of patients during the winter in the Northern Hemisphere.N Engl J Med 2009;361:1925-34.