title: A retrospective evaluation of critically ill patients infected with H1N1 influenza A virus in Bursa, Turkey, during the 2009-2010 pandemic.
abstract: BACKGROUND
  H1N1 influenza A virus infections were first reported in April 2009 and spread rapidly, resulting in mortality worldwide. The aim of this study was to evaluate patients with H1N1 infection treated in the intensive care unit (ICU) in Bursa, Turkey.
  
  
  METHODS
  Demographic characteristics, clinical features, and outcome relating to H1N1 infection were retrospectively analysed in patients treated in the ICU.
  
  
  RESULTS
  Twenty-three cases of H1N1 infection were treated in the ICU. The mean age of patients was 37 years range: (17-82). Fifteen patients were female (65.2%). The mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 19 range: (5-39). The most common symptoms were dyspnea (73.9%), fever (69.6%), and cough (60.9%). Mechanical ventilation was required for all patients. Oseltamivir and antibiotics were administered to all patients. Six (26.1%) patients died. APACHE II scores were higher in the deceased 28.5 range: [16-39] vs. 14 range: [5-28] in survivors; p = 0.013).
  
  
  CONCLUSIONS
  When compared to the literature, the demographic, epidemiological, and clinical characteristics were similar in the cases we encountered. The mortality rate was high despite the use of appropriate treatment. We believe that the high mortality is related to higher APACHE II scores. The H1N1 virus should be considered in community acquired pneumonia, especially in younger patients presenting with severe pneumonia.
authors.affiliation: Uludag University, School of Medicine, Department of Anaesthesiology and Reanimation.
authors.forename: Kelebek Girgin
authors.initials: KG
authors.lastname: Nermin
authors.affiliation: Uludag University, School of Medicine, Department of Anaesthesiology and Reanimation.
authors.forename: Iscimen
authors.initials: I
authors.lastname: Remzi
authors.affiliation: Uludag University, School of Medicine, Department of Anaesthesiology and Reanimation.
authors.forename: Akogul
authors.initials: A
authors.lastname: Zeynep
authors.affiliation: Uludag University, School of Medicine, Department of Anaesthesiology and Reanimation.
authors.forename: Cimen
authors.initials: C
authors.lastname: Ilker
authors.affiliation: Uludag University, School of Medicine, Department of Microbiology and Infectious Disease.
authors.forename: Oner Torlar
authors.initials: OT
authors.lastname: Meltem
authors.affiliation: Uludag University, School of Medicine, Department of Biostatistics.
authors.forename: Ozkaya
authors.initials: O
authors.lastname: Guven
authors.affiliation: Uludag University, School of Medicine, Department of Anaesthesiology and Reanimation.
authors.forename: Kahveci
authors.initials: K
authors.lastname: Ferda
authors.affiliation: Uludag University, School of Medicine, Department of Microbiology and Infectious Disease.
authors.forename: Akalin
authors.initials: A
authors.lastname: Halis
mesh_terms: D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D016638:Critical Illness / Q000453:epidemiology; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D053139:Oseltamivir / Q000627:therapeutic use; D058873:Pandemics; D011024:Pneumonia, Viral / Q000188:drug therapy / Q000453:epidemiology; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000998:Antiviral Agents; D053139:Oseltamivir
keywords: H1N1 infection; critically ill patient; intensive care unit; pandemic influenza