title: [Experience in the management of the severe form of human influenza A H1N1 pneumonia in an intensive care unit].
abstract: BACKGROUND
  At the beginning of the second trimester of 2009 there was an influenza A (H1N1) outbreak. The aim of this study is to describe the clinical presentation and mortality of the severe form of pneumonia in patients with human influenza A H1N1.
  
  
  METHODS
  We conducted a retrospective review of all files of confirmed and suspected patients with severe human influenza A (H1N1) pneumonia.
  
  
  RESULTS
  We studied 26 patients admitted to the ICU from April 1 to December 31, 2009, among which 16 were males (61.54%) and 10 females (38.46%) with an average age of 52.26 ± 15.48 years. The time of onset of symptoms to admission to the ICU was 6.3 ± 3.19 days. The most frequent symptoms and signs were salmonated sputum (47%), chills (45%), dry cough (44%) and myalgia (42%). The mortality rate was 19.23%. The treatment was based on antiviral therapy, modulating inflammation and ventilatory techniques to optimize oxygenation. There was an association between combined therapy based on methylprednisolone, activated protein C and statins with a better survival (p = 0.05).
  
  
  CONCLUSIONS
  Pneumonia virus of human influenza A (H1N1) is associated with high morbidity and mortality. According to our results, it is recommended to make an early diagnosis and to initiate a treatment regimen based on treatment bundles designed to optimize oxygenation, reduce viral load and modulate inflammation.
authors.affiliation: Unidad de Terapia Intensiva, Fundación Clínica Médica Sur, México, D. F., Mexico. revistacma@yahoo.com.mx
authors.forename: Raúl
authors.initials: R
authors.lastname: Carrillo-Esper
authors.forename: Jesús Ojino
authors.initials: JO
authors.lastname: Sosa-García
authors.forename: Emilio
authors.initials: E
authors.lastname: Arch-Tirado
mesh_terms: D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D015415:Biomarkers; D001798:Blood Proteins / Q000032:analysis; D003131:Combined Modality Therapy; D015897:Comorbidity; D003422:Critical Care / Q000379:methods*; D019468:Disease Management; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy; D011024:Pneumonia, Viral / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D017035:Pravastatin / Q000627:therapeutic use; D011486:Protein C / Q000627:therapeutic use; D012121:Respiration, Artificial; D012189:Retrospective Studies
chemical_list: D000893:Anti-Inflammatory Agents; D000998:Antiviral Agents; D015415:Biomarkers; D001798:Blood Proteins; D011486:Protein C; D017035:Pravastatin