14th ICID - Poster Abstracts - International Society for Infectious ...

When citing these abstracts please use the following reference:
Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number.
Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1
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Final Abstract Number: 28.007
Session: Influenza
Date: Wednesday, March 10, 2010
Time: 12:30-13:30
Room: Poster & Exhibition Area/Ground Level
Type: Poster Presentation
Clinical profile and outcome in 100 patients admitted with pandemic influenza in four intensive
care units in Uruguay during the winter of 2009
H. Bagnulo 1 , A. Soca 2 , M. Buroni 3 , G. limongi 4 , E. echavarria 5 , S. noveri 6 , M. godino 7
1 Hospital Maciel, Montevideo, Uruguay, 2 Hospital Pasteur, Montevideo, Uruguay, 3 Hospital
Español, Montevideo, Uruguay, 4 asociacion española, montevideo, Uruguay, 5 hospital maciel,
montevideo, Uruguay, 6 Hospital Pasteur, montevideo, Uruguay, 7 hospital Maciel, Montevideo,
Uruguay
Background: Pandemic Influenza Virus (AH1N1) has been identified as the cause of respiratory
infection worldwide, has been linked to severe respiratory failure requiring frequently ICU
admissions
Methods: We describe the clinical and epidemiologic characteristics of 100 patients(p)
hospitalized at these intensive care units with laboratory confirmed (RT-PCR) or acute febrile
respiratory illness epidemiologically linked.
Results: 60p were confirmed and 40 were epidemiogically suspected cases. Mean Age: 45 yrs (±
16,8); 84%< 60yrs
Clinical profile: cough ( 96%), dyspnea (93%), fever(90%), bronchospasm (51%), headache
(41%), myalgias(42%), obtundness (35%)
Risk Factors: 31p had a body mass index >30; in 13% obesity was the only risk factor. COPD
(33%), cardiovascular disease(19%), diabetes(16%), asthma(14%), pregnancy(10%). White
count cell in 70p was less than 10.000. 76p had less than 1000 lynphocites, CPK wes elevated in
60p All tested patients had elevated LDH; in 37/80 p>1000 IU, Most p (82) showed bilateral
interstitial alveolar images.
Acute Respiratoty Distress Sindrome was present in 60 p. Invasive Mechanical Ventilation was
instituted in 54 p. Alveolar recruitment maneuvers were necessary in 36 p; in 20 of which oxemia
improved. When recruitment failed prone position was instituted: 7/12p also improved
St pneumoniae was identified in 22 p (18 in tracheal aspirates and 4 in blood cultures). In 84 p
Oseltamivir was indicated; average dose 150 mg per day for 7 days . Pts who did not respond to
treatment or in obese the dose was increased to 450 mg. Corticosteroid were indicated most due
to bronchospasm(61p)
The most important complications were trombosis (7p) and Septic shock (35p).The most common
cause of death (24/28) was respiratory failure
Conclusion: The vast majority of our patients were younger than 60. High frequency of
bronchospasm, myalgia and obtundness. Obesity and pregnancy, are special risk factors.
Lymphopenia, elevated LDH and CPK represent laboratory findings. Both lungs are usually
compromised.
These patients have high mortality linked to respiratory refractory failure.