Intensive care of patients with severe influenza during the epidemic in 2016
| Autor: | Olga Titova, Vladimir Volchkov, Elizaveta Volchkova, Andrey Nefedov, Dmitry Larin |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
ARDS
Pediatrics medicine.medical_specialty business.industry Mortality rate virus diseases 030209 endocrinology & metabolism Disease medicine.disease Severe influenza 03 medical and health sciences Pneumonia Prone position 0302 clinical medicine Immunization Intensive care medicine 030212 general & internal medicine business |
| Zdroj: | Acute Critical Care. |
| DOI: | 10.1183/1393003.congress-2017.pa2125 |
| Popis: | Introduction: In mid-January 2016 the epidemic threshold for influenza disease was overpassed in St. Petersburg. The aim of the study was to analyze the treatment of patients with severe form of influenza during this period. Methods: 83 patients were admitted to the intensive care units (11% of all admissions to hospital, mean age – 56±5 years) with a complicated course of influenza on 2-8 day from the beginning of the disease. 40 patients had confirmed influenza A (H1N1), 15 - A(H3N2), 4 - combination of influenza A(H1N1) and A(H3N2), 3 - influenza B. Pneumonia was diagnosed in 74 patients, in 52 patients developed ARDS. According to anamnestic data, nobody of this group was vaccinated. Results: All patients required respiratory support. CMV with myoplegia and sedative therapy was used in 42 cases. NIPV in BIPAP and CIPAP modes was applied In 41 patients. Alveolar recruitment maneuver and ventilation with the patient in prone position were used under CMV. Therapeutic bronchoscopy with endobronchial administration of surfactant was implemented. One patient underwent ECMO) for 12 days. After 2.5 months of hospitalization this patient continued outpatient treatment. All patients underwent combined antiviral and antibacterial therapy. The mortality rate was 41%, during the first day 26 people died (31%). Conclusions: Development of severe complications of influenza has been associated with the lack of immunization, early diagnosis, timely antiviral therapy and late medical aid appealability. The timely inclusion of ECMO to the therapeutic regimen allows to treat severe hypoxemia, which is not corrected by other methods, and this increases the chances of patients’ recovery. |
| Databáze: | OpenAIRE |
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