[Acute respiratory distress syndrome during the 2009 H1N1 influenza A pandemic in Ecuador].
OBJECTIVE
Among the most severe complications caused by the influenza A virus H1N1 pandemic is the Acute Respiratory Distress Syndrome (ARDS). The main objective of this study was to assess mortality after applying a strict protocol of ventilatory management and to describe the clinical characteristics of the patients.


METHODS
A prospective cohort study.


METHODS
Intensive care unit (ICU) of the Hospital Enrique Garcés of the City of Quito.


METHODS
Patients admitted to the ICU with a diagnosis of severe pneumonia, ARDS, and high suspicion of influenza A H1N1.


METHODS
Demographic variables, severity, diagnostic scores of community-acquired pneumonia, ventilator management protocol and mortality at 28 days, as principal effect of the study, were collected.


RESULTS
24 patients were studied, 100% with a diagnosis of ARDS, mean age 41.1 (+/-14.8). Severe viral pneumonia predominated in these patients, mean APACHE was 18, average PaO(2)/FiO(2) on admission was 74.9, 100% had multisystemic involvement. A total of 91.3% received oseltamivir 150 mg w/12h for 14 days, the mean time between onset of symptoms and antiviral administration was 6.74 days. Intra-ICU mortality was 16.6%, and 28 days was 16.6%.


CONCLUSIONS
After applying a strict management protocol for ventilatory management, mortality in this patient group was 16.6. We also stress that obesity and early renal failure were independent risk factors for mortality.
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Unidad de Cuidados Intensivos, Hospital Enrique Garcés, Quito, Ecuador. rogergustavo26@hotmail.com
Cevallos
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D000293:Adolescent; D000328:Adult; D000368:Aged; D004196:Disease Outbreaks; D004484:Ecuador / Q000453:epidemiology; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000150:complications* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012128:Respiratory Distress Syndrome / Q000209:etiology* / Q000628:therapy; D055815:Young Adult