Critical Care Services and 2009 H1N1 Influenza in Australia and New Zealand.

被引：749

作者：

Webb, Steven A. R. ^{[1
,2
,3
]}

Pettila, Ville ^{[4
]}

Seppelt, Ian ^{[5
]}

Bellomo, Rinaldo ^{[4
]}

Bailey, Michael ^{[4
]}

Cooper, David J. ^{[4
,6
]}

Cretikos, Michelle ^{[7
,8
]}

Davies, Andrew R. ^{[4
,6
]}

Finfer, Simon ^{[9
]}

Harrigan, Peter W. J. ^{[10
]}

Hart, Graeme K. ^{[11
]}

Howe, Belinda ^{[4
]}

Iredell, Jonathan R. ^{[12
,13
]}

McArthur, Colin ^{[14
]}

Mitchell, Imogen ^{[15
,16
]}

Morrison, Siouxzy ^{[4
]}

Nichol, Alistair D. ^{[4
,6
]}

Paterson, David L. ^{[17
]}

Peake, Sandra ^{[18
]}

Richards, Brent ^{[19
]}

Stephens, Dianne ^{[20
]}

Turner, Andrew ^{[21
]}

Yung, Michael ^{[22
]}

机构：

[1] Royal Perth Hosp, Intens Care Unit, Perth, WA 6000, Australia

[2] Univ Western Australia, Sch Populat Hlth, Nedlands, WA 6009, Australia

[3] Univ Western Australia, Sch Med & Pharmacol, Nedlands, WA 6009, Australia

[4] Monash Univ, Sch Publ Hlth & Prevent Med, ANZIC Res Ctr, Melbourne, Vic 3004, Australia

[5] Univ Sydney, Nepean Hosp, Sydney, NSW 2006, Australia

[6] Alfred Hosp, Melbourne, Vic, Australia

[7] Univ Sydney, New S Wales Dept Hlth, Sydney, NSW 2006, Australia

[8] Univ Sydney, Sch Publ Hlth, Sydney, NSW 2006, Australia

[9] Univ Sydney, George Inst Int Hlth, Sydney, NSW 2006, Australia

[10] John Hunter Hosp, Newcastle, NSW, Australia

[11] ANZIC Soc Ctr Outcome & Resources Evaluat, Melbourne, Vic, Australia

[12] Univ Sydney, Ctr Infect Dis & Microbiol, Sydney, NSW 2006, Australia

[13] Westmead Hosp, Sydney, NSW, Australia

[14] Auckland City Hosp, Auckland, New Zealand

[15] Canberra Hosp, Canberra, ACT, Australia

[16] Australian Natl Univ, Canberra, ACT, Australia

[17] Univ Queensland, Clin Res Ctr, Brisbane, Qld, Australia

[18] Queen Elizabeth Hosp, Adelaide, SA, Australia

[19] Gold Coast Hosp, Southport, Qld, Australia

[20] Royal Darwin Hosp, Darwin, NT, Australia

[21] Royal Hobart Hosp, Intens Care Unit, Hobart, Tas, Australia

[22] Womens & Childrens Hosp Adelaide, Adelaide, SA, Australia

来源：

NEW ENGLAND JOURNAL OF MEDICINE | 2009年 / 361卷 / 20期

关键词：

MORTALITY;

D O I：

10.1056/NEJMoa0908481

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：1925 / 1934

页数：10

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