title: Myocardial dysfunction during H1N1 influenza infection.
abstract: OBJECTIVE
  The purpose of the study is to evaluate the incidence and hemodynamic consequences of right ventricular (RV) and left ventricular (LV) dysfunction in critically ill patients with H1N1 infection.
  
  
  METHODS
  This is a retrospective analysis of all patients admitted to the intensive care unit of an academic hospital between October 2009 and March 2011 with severe H1N1 infection. Hemodynamic measurements and respiratory conditions were noted daily during the intensive care unit stay.
  
  
  RESULTS
  Forty-six patients were admitted with severe H1N1 infection. Echocardiography was obtained in 39 patients on admission: 28 (72%) had abnormal ventricular function, of whom 13 (46%) had isolated LV abnormalities, 11 (39%) had isolated RV dysfunction, and 4 (14%) had biventricular dysfunction. Echocardiography was repeated in 19 of the 39 patients during their hospitalization: RV function tended to worsen with time, but LV function tended to normalize. The ventricular abnormalities were not associated with history, severity of the respiratory failure, or hemodynamic status. However, patients with ventricular dysfunction needed more aggressive therapy, including more frequent use of vasopressor and inotropic agents and of rescue ventilatory strategies, such as inhaled nitric oxide, prone positioning, and extracorporeal membrane oxygenation.
  
  
  CONCLUSIONS
  These observations emphasize the high incidence of cardiac dysfunction in patients with H1N1 influenza infections.
authors.affiliation: Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: David
authors.initials: D
authors.lastname: Fagnoul
authors.forename: Pierre
authors.initials: P
authors.lastname: Pasquier
authors.forename: Laurent
authors.initials: L
authors.lastname: Bodson
authors.forename: Julian Arias
authors.initials: JA
authors.lastname: Ortiz
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Vincent
authors.forename: Daniel
authors.initials: D
authors.lastname: De Backer
mesh_terms: D001530:Belgium / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D002302:Cardiac Output; D016009:Chi-Square Distribution; D016638:Critical Illness; D004452:Echocardiography; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006439:Hemodynamics; D006801:Humans; D015994:Incidence; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000150:complications* / Q000453:epidemiology / Q000628:therapy / Q000821:virology; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy / Q000821:virology*; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy / Q000821:virology*
chemical_list: D015415:Biomarkers
keywords: ARDS; Cardiac function; Cardiac output; Echocardiography; Myocardial depression; Oxygen delivery