2026-04-13T05:41:53Zhttps://recercat.cat/oai/request

oai:recercat.cat:10230/360362025-12-18T01:25:54Zcom_2072_6col_2072_452952

Pacientes con Gripe por Virus Influenza A (H1N1)pdm09 ingresados en UCI. Impacto de las Recomendaciones de la SEMICYUC Marin Corral, Judith Climent Company, María Cristina Muñoz Bermudez, Rosana Samper Echevarria, Maria Dot Jordana, Irene, 1982- Vilà Vilardell, Clara Masclans Enviz, Joan Ramon Rodríguez, Alejandro Martín Loeches, Ignacio Álvarez Lerma, Francisco H1N1 GETGAG/SEMICYUC Study Group Grip A (H1N1) Critically illness Enfermedad crítica Infección por virus influenza A (H1N1)pdm09 Influenza A (H1N1)pdm09 virus infection Intensive Care Unit Manejo terapéutico Mortalidad Mortality Outcome Pronóstico Therapeutic management Unidad de Cuidados Intensivos OBJECTIVES: To evaluate the impact of the recommendations of the SEMICYUC (2012) on severe influenza A. DESIGN: A prospective multicenter observational study was carried out. SETTING: ICU. PATIENTS: Patients infected with severe influenza A (H1N1) from the GETGAG/SEMICYUC registry. INTERVENTIONS: Analysis of 2 groups according to the epidemic period of the diagnosis (2009-2011; 2013-2015). VARIABLES: Demographic, temporal, comorbidities, severity, treatments, mortality, late diagnosis and place of acquisition. RESULTS: A total of 2,205 patients were included, 1,337 (60.6%) in the first period and 868 (39.4%) in the second one. Age and severity on admission were significantly greater in the second period, as well as co-infection. With regard to the impact of the recommendations, in the second period the diagnosis was established earlier (70.8 vs. 61.1%, P<.001), without changes in the start of treatment. Patients received less corticosteroid treatment (39.7 vs. 44.9%, P<.05), more NIMV was used (47.4 vs. 33.2%, P<.001) and more vaccination was made (11.1 vs. 1.7%, P<.001), without changes in mortality (24.2 vs. 20.7%). A decrease in nosocomial infection was also noted (9.8 vs. 16%, P<.001). Patients needed less MV with more days of ventilation, more vasopressor drug use and more ventral decubitus. CONCLUSIONS: The management of patients with severe influenza A (H1N1) has changed over the years, though without changes in mortality. The recommendations of the SEMICYUC (2012) have allowed earlier diagnosis and improved corticosteroid use. Pending challenges are the delay in treatment, the vaccination rate and the use of NIMV. 2018-12-12T08:34:03Z 2018 info:eu-repo/semantics/article info:eu-repo/semantics/acceptedVersion Medicina intensiva. 2018 Nov;42(8):473-81 © Elsevier http://dx.doi.org/10.1016/j.medin.2018.02.002 info:eu-repo/semantics/openAccess Elsevier