title: Long-term outcomes of pandemic 2009 influenza A(H1N1)-associated severe ARDS.
abstract: BACKGROUND
  No data on long-term outcomes of survivors of 2009 influenza A(H1N1) (A[H1N1])-associated ARDS are available. The objective of this study was to compare the 1-year outcomes of survivors of A(H1N1)-associated ARDS, according to use or no use of extracorporeal lung assist (ECLA), using its need as an ARDS severity surrogate.
  
  
  METHODS
  Survivors of ARDS (12 with ECLA use vs 25 without, corresponding to 75% and 54% of the eligible patients for each group, respectively) selected from the Réseau Européen de Ventilation Artificielle (REVA) registry had previously been healthy, with only pregnancy and/or moderate obesity (BMI ≤ 35 kg/m²) as known risk factors for A(H1N1) infection. Lung function and morphology, health-related quality of life (HRQoL), and psychologic impairment were evaluated.
  
  
  RESULTS
  At 1 year post-ICU discharge for the ECLA and no-ECLA groups, respectively, 50% and 40% reported significant exertion dyspnea, 83% and 64% had returned to work, and 75% and 64% had decreased diffusion capacity across the blood-gas barrier, despite their near-normal and similar lung function test results. For both groups, exercise test results showed diminished but comparable exercise capacities, with similar alveolar-arterial oxygen gradients at peak exercise, and CT scans showed minor abnormal findings. HRQoL assessed by the 36-Item Short-Form Health Survey was poorer for both groups than for a sex- and age-matched general population group, but without between-group differences. ECLA and no-ECLA group patients, respectively, had symptoms of anxiety (50% and 56%) and depression (28% and 28%) and were at risk for posttraumatic stress disorder (41% and 44%).
  
  
  CONCLUSIONS
  One year post-ICU discharge, a majority of survivors of A(H1N1)-associated ARDS had minor lung disabilities with diminished diffusion capacities across the blood-gas barrier, and most had psychologic impairment and poorer HRQoL than a sex- and age-matched general population group. ECLA and no-ECLA group patients had comparable outcomes.
  
  
  BACKGROUND
  ClinicalTrials.gov; No.: NCT01271842; URL: www.clinicaltrials.gov
authors.affiliation: Service de Réanimation Médicale, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris et Université Paris 6-Pierre-et-Marie-Curie, Paris France. Electronic address: charles-edouard.luyt@psl.aphp.fr.
authors.forename: Charles-Edouard
authors.initials: CE
authors.lastname: Luyt
authors.affiliation: Service de Réanimation Médicale, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris et Université Paris 6-Pierre-et-Marie-Curie, Paris France.
authors.forename: Alain
authors.initials: A
authors.lastname: Combes
authors.affiliation: Service d'Explorations Fonctionnelles, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris et Université Paris 6-Pierre-et-Marie-Curie, Paris France.
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Becquemin
authors.affiliation: Service de Radiologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris et Université Paris 6-Pierre-et-Marie-Curie, Paris France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Beigelman-Aubry
authors.affiliation: Service d'explorations fonctionnelles cardio-vasculaires, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris et Université Paris 6-Pierre-et-Marie-Curie, Paris France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Hatem
authors.affiliation: Service de Radiologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris et Université Paris 6-Pierre-et-Marie-Curie, Paris France.
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Brun
authors.affiliation: Service d'Explorations Fonctionnelles, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris et Université Paris 6-Pierre-et-Marie-Curie, Paris France.
authors.forename: Nizar
authors.initials: N
authors.lastname: Zraik
authors.affiliation: Service de Santé Publique, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Unité Mixte de Recherche-S 707, Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris 6-Pierre-et-Marie-Curie, Paris, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Carrat
authors.affiliation: Service de Radiologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris et Université Paris 6-Pierre-et-Marie-Curie, Paris France.
authors.forename: Philippe A
authors.initials: PA
authors.lastname: Grenier
authors.affiliation: Service de Réanimation Médicale, Centre Hospitalier Universitaire de Rouen, Rouen.
authors.forename: Jean-Christophe M
authors.initials: JM
authors.lastname: Richard
authors.affiliation: Service de Réanimation Médicale, Centre Hospitalier Universitaire d'Angers, Angers, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Mercat
authors.affiliation: Intensive Care Unit, Hôpitaux Universitaires de Genève, Genève, Switzerland.
authors.forename: Laurent
authors.initials: L
authors.lastname: Brochard
authors.affiliation: Service de Réanimation Médicale, Hôpital Henri-Mondor, Assistance Publique-Hôpitaux de Paris, Université Paris 12, Créteil, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Brun-Buisson
authors.affiliation: Service de Réanimation Médicale, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris et Université Paris 6-Pierre-et-Marie-Curie, Paris France.
authors.forename: Jean
authors.initials: J
authors.lastname: Chastre
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology; D016022:Case-Control Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000150:complications* / Q000453:epidemiology*; D008137:Longitudinal Studies; D008168:Lung / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D058873:Pandemics; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D012042:Registries; D012128:Respiratory Distress Syndrome / Q000209:etiology* / Q000523:psychology / Q000628:therapy*; D012129:Respiratory Function Tests; D012138:Respiratory Therapy / Q000379:methods; D012189:Retrospective Studies; D013256:Steroids / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D013256:Steroids