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dc.contributor.authorMartin-Loeches, I
dc.contributor.authorLisboa, T
dc.contributor.authorRhodes, A
dc.contributor.authorMoreno, R P
dc.contributor.authorSilva, E
dc.contributor.authorSprung, C
dc.contributor.authorChiche, J D
dc.contributor.authorBarahona, D
dc.contributor.authorVillabon, M
dc.contributor.authorBalasini, C
dc.contributor.authorPearse, R M
dc.contributor.authorMatos, R
dc.contributor.authorRello, J
dc.date.accessioned2011-12-23T10:42:53Z
dc.date.available2011-12-23T10:42:53Z
dc.date.issued2011-02
dc.identifier.citationUse of early corticosteroid therapy on ICU admission in patients affected by severe pandemic (H1N1)v influenza A infection. 2011, 37 (2):272-83 Intensive Care Meden
dc.identifier.issn1432-1238
dc.identifier.pmid21107529
dc.identifier.doi10.1007/s00134-010-2078-z
dc.identifier.urihttp://hdl.handle.net/10147/198830
dc.descriptionINTRODUCTION: Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection, although relatively common, remains controversial. METHODS: Prospective, observational, multicenter study from 23 June 2009 through 11 February 2010, reported in the European Society of Intensive Care Medicine (ESICM) H1N1 registry. RESULTS: Two hundred twenty patients admitted to an intensive care unit (ICU) with completed outcome data were analyzed. Invasive mechanical ventilation was used in 155 (70.5%). Sixty-seven (30.5%) of the patients died in ICU and 75 (34.1%) whilst in hospital. One hundred twenty-six (57.3%) patients received corticosteroid therapy on admission to ICU. Patients who received corticosteroids were significantly older and were more likely to have coexisting asthma, chronic obstructive pulmonary disease (COPD), and chronic steroid use. These patients receiving corticosteroids had increased likelihood of developing hospital-acquired pneumonia (HAP) [26.2% versus 13.8%, p < 0.05; odds ratio (OR) 2.2, confidence interval (CI) 1.1-4.5]. Patients who received corticosteroids had significantly higher ICU mortality than patients who did not (46.0% versus 18.1%, p < 0.01; OR 3.8, CI 2.1-7.2). Cox regression analysis adjusted for severity and potential confounding factors identified that early use of corticosteroids was not significantly associated with mortality [hazard ratio (HR) 1.3, 95% CI 0.7-2.4, p = 0.4] but was still associated with an increased rate of HAP (OR 2.2, 95% CI 1.0-4.8, p < 0.05). When only patients developing acute respiratory distress syndrome (ARDS) were analyzed, similar results were observed. CONCLUSIONS: Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection did not result in better outcomes and was associated with increased risk of superinfections.en
dc.description.abstractEarly use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection, although relatively common, remains controversial.
dc.description.abstractProspective, observational, multicenter study from 23 June 2009 through 11 February 2010, reported in the European Society of Intensive Care Medicine (ESICM) H1N1 registry.
dc.description.abstractTwo hundred twenty patients admitted to an intensive care unit (ICU) with completed outcome data were analyzed. Invasive mechanical ventilation was used in 155 (70.5%). Sixty-seven (30.5%) of the patients died in ICU and 75 (34.1%) whilst in hospital. One hundred twenty-six (57.3%) patients received corticosteroid therapy on admission to ICU. Patients who received corticosteroids were significantly older and were more likely to have coexisting asthma, chronic obstructive pulmonary disease (COPD), and chronic steroid use. These patients receiving corticosteroids had increased likelihood of developing hospital-acquired pneumonia (HAP) [26.2% versus 13.8%, p < 0.05; odds ratio (OR) 2.2, confidence interval (CI) 1.1-4.5]. Patients who received corticosteroids had significantly higher ICU mortality than patients who did not (46.0% versus 18.1%, p < 0.01; OR 3.8, CI 2.1-7.2). Cox regression analysis adjusted for severity and potential confounding factors identified that early use of corticosteroids was not significantly associated with mortality [hazard ratio (HR) 1.3, 95% CI 0.7-2.4, p = 0.4] but was still associated with an increased rate of HAP (OR 2.2, 95% CI 1.0-4.8, p < 0.05). When only patients developing acute respiratory distress syndrome (ARDS) were analyzed, similar results were observed.
dc.description.abstractEarly use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection did not result in better outcomes and was associated with increased risk of superinfections.
dc.language.isoenen
dc.publisherSpringeren
dc.subject.meshAdrenal Cortex Hormones
dc.subject.meshAdult
dc.subject.meshCross Infection
dc.subject.meshEurope
dc.subject.meshFemale
dc.subject.meshHumans
dc.subject.meshInfluenza A Virus, H1N1 Subtype
dc.subject.meshInfluenza, Human
dc.subject.meshIntensive Care Units
dc.subject.meshLikelihood Functions
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshPandemics
dc.subject.meshPneumonia
dc.subject.meshProspective Studies
dc.subject.meshRegistries
dc.subject.meshSeverity of Illness Index
dc.subject.meshSurvival Analysis
dc.titleUse of early corticosteroid therapy on ICU admission in patients affected by severe pandemic (H1N1)v influenza A infection.en
dc.typeArticleen
dc.contributor.departmentCritical Care Department, Joan XXIII University Hospital, University Rovira i Virgili, IISPV, CIBER Enfermedades Respiratorias (CIBERes), Tarragona, Spain.en
dc.identifier.journalIntensive care medicineen
dc.description.provinceMunster
html.description.abstractEarly use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection, although relatively common, remains controversial.
html.description.abstractProspective, observational, multicenter study from 23 June 2009 through 11 February 2010, reported in the European Society of Intensive Care Medicine (ESICM) H1N1 registry.
html.description.abstractTwo hundred twenty patients admitted to an intensive care unit (ICU) with completed outcome data were analyzed. Invasive mechanical ventilation was used in 155 (70.5%). Sixty-seven (30.5%) of the patients died in ICU and 75 (34.1%) whilst in hospital. One hundred twenty-six (57.3%) patients received corticosteroid therapy on admission to ICU. Patients who received corticosteroids were significantly older and were more likely to have coexisting asthma, chronic obstructive pulmonary disease (COPD), and chronic steroid use. These patients receiving corticosteroids had increased likelihood of developing hospital-acquired pneumonia (HAP) [26.2% versus 13.8%, p < 0.05; odds ratio (OR) 2.2, confidence interval (CI) 1.1-4.5]. Patients who received corticosteroids had significantly higher ICU mortality than patients who did not (46.0% versus 18.1%, p < 0.01; OR 3.8, CI 2.1-7.2). Cox regression analysis adjusted for severity and potential confounding factors identified that early use of corticosteroids was not significantly associated with mortality [hazard ratio (HR) 1.3, 95% CI 0.7-2.4, p = 0.4] but was still associated with an increased rate of HAP (OR 2.2, 95% CI 1.0-4.8, p < 0.05). When only patients developing acute respiratory distress syndrome (ARDS) were analyzed, similar results were observed.
html.description.abstractEarly use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection did not result in better outcomes and was associated with increased risk of superinfections.


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