title: Interest of a simple on-line screening registry for measuring ICU burden related to an influenza pandemic.
abstract: BACKGROUND
  The specific burden imposed on Intensive Care Units (ICUs) during the A/H1N1 influenza 2009 pandemic has been poorly explored. An on-line screening registry allowed a daily report of ICU beds occupancy rate by flu infected patients (Flu-OR) admitted in French ICUs.
  
  
  METHODS
  We conducted a prospective inception cohort study with results of an on-line screening registry designed for daily assessment of ICU burden.
  
  
  RESULTS
  Among the 108 centers participating to the French H1N1 research network on mechanical ventilation (REVA) - French Society of Intensive Care (SRLF) registry, 69 ICUs belonging to seven large geographical areas voluntarily participated in a website screening-registry. The aim was to daily assess the ICU beds occupancy rate by influenza-infected and non-infected patients for at least three weeks. Three hundred ninety-one critically ill infected patients were enrolled in the cohort, representing a subset of 35% of the whole French 2009 pandemic cohort; 73% were mechanically ventilated, 13% required extra corporal membrane oxygenation (ECMO) and 22% died. The global Flu-OR in these ICUs was only 7.6%, but it exceeded a predefined 15% critical threshold in 32 ICUs for a total of 103 weeks. Flu-ORs were significantly higher in University than in non-University hospitals. The peak ICU burden was poorly predicted by observations obtained at the level of large geographical areas.
  
  
  CONCLUSIONS
  The peak Flu-OR during the pandemic significantly exceeded a 15% critical threshold in almost half of the ICUs, with an uneven distribution with time, geographical areas and between University and non-University hospitals. An on-line assessment of Flu-OR via a simple dedicated registry may contribute to better match resources and needs.
authors: Jean-Christophe Marie
authors: JC
authors: Richard
authors: Tài
authors: T
authors: Pham
authors: Christian
authors: C
authors: Brun-Buisson
authors: Jean
authors: J
authors: Reignier
authors: Alain
authors: A
authors: Mercat
authors: Gaëtan
authors: G
authors: Beduneau
authors: Bernard
authors: B
authors: Régnier
authors: Bruno
authors: B
authors: Mourvillier
authors: Christophe
authors: C
authors: Guitton
authors: Matthias
authors: M
authors: Castanier
authors: Alain
authors: A
authors: Combes
authors: Yves
authors: Y
authors: Le Tulzo
authors: Laurent
authors: L
authors: Brochard
mesh_terms: D000328:Adult; D001509:Bed Occupancy / Q000706:statistics & numerical data*; D016638:Critical Illness / Q000453:epidemiology; D015199:Extracorporeal Membrane Oxygenation / Q000706:statistics & numerical data; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology*; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009862:Online Systems; D058873:Pandemics; D011446:Prospective Studies; D012042:Registries; D012121:Respiration, Artificial / Q000706:statistics & numerical data