Abstract
BackgroundIn Poland, little is known about the most serious cases of influenza that need admittance to the intensive care unit (ICU), as well as the use of extracorporeal respiratory support.MethodsThis was an electronic survey comprising ICUs in two administrative regions of Poland. The aim of the study was to determine the number of influenza patients with respiratory failure admitted to the ICU in the autumn–winter season of 2018/2019. Furthermore, respiratory support, outcome and other pathogens detected in the airways were investigated.ResultsInfluenza infection was confirmed in 76 patients. The A(H1N1)pdm09 strain was the most common. 34 patients died (44.7%). The median age was 62 years, the median sequential organ failure assessment (SOFA) score was 11 and was higher in patients who died (12 vs. 10, p = 0.017). Mechanical ventilation was used in 75 patients and high flow nasal oxygen therapy in 1 patient. Extracorporeal membrane oxygenation (ECMO) was used in 7 patients (6 survived), and extracorporeal carbon dioxide removal (ECCO2R) in 2 (1 survived). The prone position was used in 16 patients. In addition, other pathogens were detected in the airways on admittance to the ICU.ConclusionA substantial number of influenza infections occurred in the autumn–winter season of 2018/2019 that required costly treatment in the intensive care units. Upon admission to the ICU, influenza patients had a high degree of organ failure as assessed by the SOFA score, and the mortality rate was 44.7%. Advanced extracorporeal respiratory techniques offer real survival opportunities to patients with severe influenza-related ARDS. The presence of coinfection should be considered in patients with influenza and respiratory failure.
Highlights
In Poland, little is known about the most serious cases of influenza that need admittance to the inten‐ sive care unit (ICU), as well as the use of extracorporeal respiratory support
We investigated the incidence of influenza in patients with respiratory failure admitted to adult intensive care units in two administrative regions of Poland, the Lower Silesia and Opole voivodeships, in the autumn–winter season of 2018/2019
The mean age (62 years) and mortality (44.7%) of these patients did not differ from the average age and mortality of patients in all ICUs in Poland (63.1 years and 42%, respectively) [6] and mortality is consistent with the sequential organ failure assessment (SOFA) score predicted mortality [7]
Summary
In Poland, little is known about the most serious cases of influenza that need admittance to the inten‐ sive care unit (ICU), as well as the use of extracorporeal respiratory support. Smiechowicz et al BMC Infect Dis (2021) 21:954 patients may need admission to the intensive care unit (ICU), mostly because of respiratory distress [1, 2]. In those with the most severe respiratory failure the use of extracorporeal techniques of respiratory support is warranted [3]. The most serious cases need admittance to the ICU, yet little is known about the number of such cases and the use of extracorporeal respiratory support in this patient population
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