Patients with Influenza A Subtype H3N2 and Ventilatory Support During A Seasonal Outbreak in an Emergency Department in Argentina / Pacientes con Influenza A subtipo H3N2 y soporte ventilatorio durante el brote estacional en una central de emergencias en Argentina
Rev. am. med. respir
;
19(4): 268-276, sept. 2019. tab
Article
in English
| LILACS, BINACIS
| ID: biblio-1119736
ABSTRACT
Objective:
To describe the characteristics of patients with influenza A subtype H3N2 requiring ventilatory support during the 2017 outbreak, as well as the evolution of the disease and clinical results. Materials andMethods:
Retrospective cohort. We included all patients admitted to the Emergency Department with confirmed diagnosis of H3N2 during June 2017, requiring invasive or noninvasive mechanical respiratory assistance, high-flow nasal cannula treatment or continuous airway pressure.Results:
34 patients were included; 52.9% men, mean age 81 years (Standard Deviation [SD] 10). Main comorbidities of patients on admission were 73.5% hypertension, 44.1% chronic obstructive pulmonary disease and 76.5% congestive heart failure. The mean Charlson Index score was 6 (SD 2), the APACHE II median (Acute Physiology and Chronic Health Evaluation II) was 17 (IQR 14-20) and the SOFA median (Sequential Organ Failure Assessment) on day 1 was 5 (IQR 3-7). On admission, 23 patients required noninvasive ventilation, 5 continuous positive airway pressure, 4 invasive mechanical ventilation and 2 high-flow nasal cannula therapy. The rate of noninvasive ventilation failure was 47.8% (95% CI [confidence interval] 26.8-69.4) and finally 38.2% of patients were intubated and mechanically ventilated. Hospital mortality was 52.9% (95% CI 35.1-70.2).Conclusions:
A high mortality rate was observed among elderly patients with comorbidities during the H3N2 outbreak. Most patients underwent a noninvasive ventilation trial on admission, however a high percentage failed. The initial condition could have been interpreted as acute chronic obstructive pulmonary disease or congestive heart failure.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Influenza in Birds
Limits:
Humans
Country/Region as subject:
South America
/
Argentina
Language:
English
Journal:
Rev. am. med. respir
Journal subject:
Medicine
/
Pulmonary Disease (Specialty)
Year:
2019
Type:
Article
Affiliation country:
Argentina
Institution/Affiliation country:
Hospital Italiano de Buenos Aires/AR
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