title: Surge in Hospitalizations Associated With Mechanical Ventilator Use During Influenza Outbreaks.
abstract: OBJECTIVE
  Information on surges in critical care services including mechanical ventilator use during seasonal influenza outbreaks is limited. To potentially facilitate preparedness plans for future pandemics, we retrospectively quantitated surges in all-cause mechanical ventilator use during peak influenza for 12 consecutive years in all certified hospitals in Maryland.
  
  
  METHODS
  Influenza testing data obtained for the Centers for Disease Control and Protection, Health and Human Services region 3, included defined peak influenza outbreak periods (PIOP), non-influenza time periods (non-ITP), and proportions of circulating influenza types for all study years. Procedure codes for mechanical ventilator use and diagnostic codes for medically attended acute respiratory illness (MAARI) were reviewed for every Maryland hospitalization. Daily counts of hospitalizations associated with ventilator use or MAARI during PIOP compared to non-ITP were analyzed using Poisson regression adjusted for month and year.
  
  
  RESULTS
  Ventilator use increased during PIOP by 7% (95% CI, 5-10) over non-ITP (P< .0001) for all study years. These annual surges correlated with influenza season intensity, as measured by MAARI-related hospitalizations (correlation coefficient = 0.91,P< .0001).
  
  
  CONCLUSIONS
  Surges in ventilator use were temporally associated with PIOP and were positively correlated with influenza season intensity, as measured by hospitalizations associated with acute respiratory illness. This information may assist resource planning for future pandemics. (Disaster Med Public Health Preparedness. 2014;x:1-7).
authors.affiliation: Tunnell Consulting, Washington, DC.
authors.forename: James C
authors.initials: JC
authors.lastname: King
authors.affiliation: Gap Solutions, Washington, DC.
authors.forename: Adebola
authors.initials: A
authors.lastname: Ajao
authors.affiliation: Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Richard
authors.initials: R
authors.lastname: Lichenstein
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Laurence S
authors.initials: LS
authors.lastname: Magder
keywords: hospitalized patients.; influenza outbreaks; mechanical ventilators; medically attended acute respiratory illness