TY - JOUR
T1 - Critical care services and 2009 H1N1 influenza in Australia and New Zealand
AU - Webb, Steve
AU - Pettila, V.
AU - Seppelt, I.
AU - Bellomo, R.
AU - Bailey, M.
AU - Cooper, D.J.
AU - Cretikos, M.
AU - Davies, A.R.
AU - Finfer, S.
AU - Harrigan, P.W.J.
AU - Hart, G.K.
AU - Howe, B.
AU - Iredell, J.R.
AU - Mcarthur, C.
AU - Mitchell, I.
AU - Morrison, S.
AU - Nichol, A.D.
AU - Paterson, D.L.
AU - Peake, S.
AU - Richards, B.
AU - Stephens, D.
AU - Turner, Angus
AU - Yung, M.
PY - 2009
Y1 - 2009
N2 - BACKGROUNDPlanning for the treatment of infection with the 2009 pandemic influenza A (H1N1)virus through health care systems in developed countries during winter in the NorthernHemisphere is hampered by a lack of information from similar health caresystems.METHODSWe conducted an inception-cohort study in all Australian and New Zealand intensivecare units (ICUs) during the winter of 2009 in the Southern Hemisphere. We calculated,per million inhabitants, the numbers of ICU admissions, bed-days, and daysof mechanical ventilation due to infection with the 2009 H1N1 virus. We collecteddata on demographic and clinical characteristics of the patients and on treatmentsand outcomes.RESULTSFrom June 1 through August 31, 2009, a total of 722 patients with confirmed infectionwith the 2009 H1N1 virus (28.7 cases per million inhabitants; 95% confidenceinterval [CI], 26.5 to 30.8) were admitted to an ICU in Australia or New Zealand. Ofthe 722 patients, 669 (92.7%) were under 65 years of age and 66 (9.1%) were pregnantwomen; of the 601 adults for whom data were available, 172 (28.6%) had abody-mass index (the weight in kilograms divided by the square of the height inmeters) greater than 35. Patients infected with the 2009 H1N1 virus were in the ICUfor a total of 8815 bed-days (350 per million inhabitants). The median duration oftreatment 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 medianof 8 days (interquartile range, 4 to 16). The maximum daily occupancy of the ICUwas 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.CONCLUSIONSThe 2009 H1N1 virus had a substantial effect on ICUs during the winter in Australiaand New Zealand. Our data can assist planning for the treatment of patients duringthe winter in the Northern Hemisphere.
AB - BACKGROUNDPlanning for the treatment of infection with the 2009 pandemic influenza A (H1N1)virus through health care systems in developed countries during winter in the NorthernHemisphere is hampered by a lack of information from similar health caresystems.METHODSWe conducted an inception-cohort study in all Australian and New Zealand intensivecare units (ICUs) during the winter of 2009 in the Southern Hemisphere. We calculated,per million inhabitants, the numbers of ICU admissions, bed-days, and daysof mechanical ventilation due to infection with the 2009 H1N1 virus. We collecteddata on demographic and clinical characteristics of the patients and on treatmentsand outcomes.RESULTSFrom June 1 through August 31, 2009, a total of 722 patients with confirmed infectionwith the 2009 H1N1 virus (28.7 cases per million inhabitants; 95% confidenceinterval [CI], 26.5 to 30.8) were admitted to an ICU in Australia or New Zealand. Ofthe 722 patients, 669 (92.7%) were under 65 years of age and 66 (9.1%) were pregnantwomen; of the 601 adults for whom data were available, 172 (28.6%) had abody-mass index (the weight in kilograms divided by the square of the height inmeters) greater than 35. Patients infected with the 2009 H1N1 virus were in the ICUfor a total of 8815 bed-days (350 per million inhabitants). The median duration oftreatment 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 medianof 8 days (interquartile range, 4 to 16). The maximum daily occupancy of the ICUwas 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.CONCLUSIONSThe 2009 H1N1 virus had a substantial effect on ICUs during the winter in Australiaand New Zealand. Our data can assist planning for the treatment of patients duringthe winter in the Northern Hemisphere.
U2 - 10.1056/NEJMoa0908481
DO - 10.1056/NEJMoa0908481
M3 - Article
C2 - 19815860
SN - 0028-4793
VL - 361
SP - 1925
EP - 1934
JO - The New England Journal of Medicine
JF - The New England Journal of Medicine
IS - 20
ER -