Use of early corticosteroid therapy on ICU admission in patients affected by severe pandemic (H1N1)v influenza A infection

Ignacio Martin-Loeches; Thiago Lisboa; Andrew Rhodes; R. P. Moreno; Eliezer Silva; C. Sprung; Jean Daniel Chiche; Diego Barahona; Mario Villabon; Carina Balasini; Rupert Pearse; Ricardo Matos; Jordi Rello; Alejandro Rodriguez; Maurizia Capuzzo; Rosa Reina; Brian Marsh; Haans Flaaten; Gisli Sigurdsson; Zykova Ivana; Vladimir Cerny; Michael Quintel; Tobias Welte; Manuel Mayorga; Georges Offenstadt; Bertrand Guidet; Phillip Levin; Hans Ulrich Rothen; Charles Gomersall; Seyed Mohammadreza Hashemian; Constantine Katsanoulas; Heleni Mouloudi; Farhad Kapadia; Andreas Valentin; Goran Hedenstierna; Anders Perner; Guillermo Bugedo; Esko Ruokonen; Antoni Soriano Arandes; Juan C. Montejo; Ramón Peñíscola; Cecilia Hermosa; Federico Gordo; Jaime Latour; Loreto Vidaur; Manuel Alvarez-Gonzalez; Luis Alvarez-Rocha; Ana De Pablo; Cristina Ferri; Lopez De Arbina Martinez; Cortés Cânones; Josu Insausti; Jose Cambronero; Beatriz Galvan; José Luna; Rafael Blancas; Carmen Garcia; Rafael Sierra; Francisco Fernández Dorado; Pablo Monedero; Jose Llagunes; Pedro Cobo; Antonia Socias; Rafael Leon-Lopez; Elisabeth Esteban; Marquina Lacueva; Monica Magret; Frutos Del Nogal; Alexandra Dinis; Anabela Bártolo; Armindo Ramos; Carlos Franca; Celso Estevens; Cristina Granja; Custódio Fidalgo; Eduardo Almeida; Estevão Lafuente; Fernando Rua; Francisco Esteves; José Clemente; José Júlio Nóbrega; José Manuel Pereira; José Pedro Moura; Luís Paulo Trindade E Silva; Luís Telo; Lurdes Santos; Maria José Pedrosa; Maria Oliveira; Margarida Resende; Nuno Catorze; Paula Coutinho; Rosa Ribeiro; Rui Moreno; Isabel Miranda; Teresa Cardoso; Vítor Branco; Giacomo Bellani; Ros Urbino; Adriano Peris; Alessandro Amatu; Giorgio Berlot; Federico Capra Marzani; Ulisse Corbanese; Antonio David; Paolo Chiarandini; Francesco Della Corte; Maria Luisa Caspani; Conio Alessandra; Valerio Mangani; Romano Tetamo; Andrea Wolfler; Giuseppe Tappatà; Vivaldi Nicoletta; Guido Bertolini; Lorella Pelagalli; Alexandre Molin; Massimo Girardis; Giuseppe Gristin; Ammy Lam; Ian Crabb; Rebecca Cusack; Rhiannon Jackson; Chithambaram Veerappan; Craig Whiteley; Tony Ware; Stephan Krueper; Caleb Mckinstry; Andrew Ferguson; Francesca Rubulotta; Erick Valencia; Susana Gonzalez; Victor Cevallos; Alan Zazu; Jeronimo Nahuel Chaparro Fresco; Gabriel Galindez; Cecilia Barrios; Carlos Lovesio; Boris Villamagua; Mario Cadena; Estuardo Salgado; Marià Fernanda García; Gustavo Paredes; Maria Donnelly; Donall O'Croinin; John Bates; Niall Kavanagh; Brian O'Brien; Rob Plant; Michael Scully; Rachel Farragher; Louise Oliveira; Sergio Mataloun; Vicente Souza Dantas; Luiz Simvoulidis; Péricles Duarte; Cintia Grion; Almir Germano; Jon Henrik Laake; Elin Helset; Dagny Klausen; Hans Flaatten; Kari Bruheim; Bjarki Kristinsson; Sigurdur E. Sigurdsson; Jan Hrubý; Radka Valkova; Robert Janda; Ivana Zykova; Andrea Kernchen; Frank Bloos; Simone Rosseau; Jens Krassler; Frank Fischer; Abel Arroyo-Sanchez; Alejandro Barrionuevo Poquet; Ivan Ramos Palomino; Fabiola Rafael; Juan Salasfoch; Gregory Dubar; Jean Marie Tonnelier; Saber Barbar; Murielle Dobrzynski; Alexandre Mignon; Daniel Jakobson; Moti Klein; Eran Segal; Yaron Barlavie; Moshe Hersch; Zule Sicardi Salomón; Hervé Zender; Hans U. Rothen; Kenny Chan; Tom Buckley; Uros Batranovic; Ilons Schaffer; Jelena Sretkovic; Despoina Koulenti; Eleni Mouloudi; Phyllis Maria Clouva-Molyvdas; Mohan Gurjar; Deepak Vijayan; Georg Hinterholzer; Alexander Kulier; Carin Verlaat; Dirk Ebel; Johan Persson; Sten Walther; Per Petersen; Walter Swinnen; Vincent Collin; Hanne Olsen; Patricio Gutierrez; Guillaume Thiery; Heikki Laine; Arvydas Rumba; Sundaresan Maiyalagan; Thinh Bui

doi:10.1007/s00134-010-2078-z

Use of early corticosteroid therapy on ICU admission in patients affected by severe pandemic (H1N1)v influenza A infection

Ignacio Martin-Loeches, Thiago Lisboa, Andrew Rhodes, R. P. Moreno, Eliezer Silva, C. Sprung, Jean Daniel Chiche, Diego Barahona, Mario Villabon, Carina Balasini, Rupert Pearse, Ricardo Matos, Jordi Rello^*, Alejandro Rodriguez, Maurizia Capuzzo, Rosa Reina, Brian Marsh, Haans Flaaten, Gisli Sigurdsson, Zykova IvanaVladimir Cerny, Michael Quintel, Tobias Welte, Manuel Mayorga, Georges Offenstadt, Bertrand Guidet, Phillip Levin, Hans Ulrich Rothen, Charles Gomersall, Seyed Mohammadreza Hashemian, Constantine Katsanoulas, Heleni Mouloudi, Farhad Kapadia, Andreas Valentin, Goran Hedenstierna, Anders Perner, Guillermo Bugedo, Esko Ruokonen, Antoni Soriano Arandes, Juan C. Montejo, Ramón Peñíscola, Cecilia Hermosa, Federico Gordo, Jaime Latour, Loreto Vidaur, Manuel Alvarez-Gonzalez, Luis Alvarez-Rocha, Ana De Pablo, Cristina Ferri, Lopez De Arbina Martinez, Cortés Cânones, Josu Insausti, Jose Cambronero, Beatriz Galvan, José Luna, Rafael Blancas, Carmen Garcia, Rafael Sierra, Francisco Fernández Dorado, Pablo Monedero, Jose Llagunes, Pedro Cobo, Antonia Socias, Rafael Leon-Lopez, Elisabeth Esteban, Marquina Lacueva, Monica Magret, Frutos Del Nogal, Alexandra Dinis, Anabela Bártolo, Armindo Ramos, Carlos Franca, Celso Estevens, Cristina Granja, Custódio Fidalgo, Eduardo Almeida, Estevão Lafuente, Fernando Rua, Francisco Esteves, José Clemente, José Júlio Nóbrega, José Manuel Pereira, José Pedro Moura, Luís Paulo Trindade E Silva, Luís Telo, Lurdes Santos, Maria José Pedrosa, Maria Oliveira, Margarida Resende, Nuno Catorze, Paula Coutinho, Rosa Ribeiro, Rui Moreno, Isabel Miranda, Teresa Cardoso, Vítor Branco, Giacomo Bellani, Ros Urbino, Adriano Peris, Alessandro Amatu, Giorgio Berlot, Federico Capra Marzani, Ulisse Corbanese, Antonio David, Paolo Chiarandini, Francesco Della Corte, Maria Luisa Caspani, Conio Alessandra, Valerio Mangani, Romano Tetamo, Andrea Wolfler, Giuseppe Tappatà, Vivaldi Nicoletta, Guido Bertolini, Lorella Pelagalli, Alexandre Molin, Massimo Girardis, Giuseppe Gristin, Ammy Lam, Ian Crabb, Rebecca Cusack, Rhiannon Jackson, Chithambaram Veerappan, Craig Whiteley, Tony Ware, Stephan Krueper, Caleb Mckinstry, Andrew Ferguson, Francesca Rubulotta, Erick Valencia, Susana Gonzalez, Victor Cevallos, Alan Zazu, Jeronimo Nahuel Chaparro Fresco, Gabriel Galindez, Cecilia Barrios, Carlos Lovesio, Boris Villamagua, Mario Cadena, Estuardo Salgado, Marià Fernanda García, Gustavo Paredes, Maria Donnelly, Donall O'Croinin, John Bates, Niall Kavanagh, Brian O'Brien, Rob Plant, Michael Scully, Rachel Farragher, Louise Oliveira, Sergio Mataloun, Vicente Souza Dantas, Luiz Simvoulidis, Péricles Duarte, Cintia Grion, Almir Germano, Jon Henrik Laake, Elin Helset, Dagny Klausen, Hans Flaatten, Kari Bruheim, Bjarki Kristinsson, Sigurdur E. Sigurdsson, Jan Hrubý, Radka Valkova, Robert Janda, Ivana Zykova, Andrea Kernchen, Frank Bloos, Simone Rosseau, Jens Krassler, Frank Fischer, Abel Arroyo-Sanchez, Alejandro Barrionuevo Poquet, Ivan Ramos Palomino, Fabiola Rafael, Juan Salasfoch, Gregory Dubar, Jean Marie Tonnelier, Saber Barbar, Murielle Dobrzynski, Alexandre Mignon, Daniel Jakobson, Moti Klein, Eran Segal, Yaron Barlavie, Moshe Hersch, Zule Sicardi Salomón, Hervé Zender, Hans U. Rothen, Kenny Chan, Tom Buckley, Uros Batranovic, Ilons Schaffer, Jelena Sretkovic, Despoina Koulenti, Eleni Mouloudi, Phyllis Maria Clouva-Molyvdas, Mohan Gurjar, Deepak Vijayan, Georg Hinterholzer, Alexander Kulier, Carin Verlaat, Dirk Ebel, Johan Persson, Sten Walther, Per Petersen, Walter Swinnen, Vincent Collin, Hanne Olsen, Patricio Gutierrez, Guillaume Thiery, Heikki Laine, Arvydas Rumba, Sundaresan Maiyalagan, Thinh Bui

^*Corresponding author for this work

Faculty of Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

Introduction: Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection, although relatively common, remains controversial. Methods: Prospective, observational, multicenter study from 23 June 2009 through 11 February 2010, reported in the European Society of Intensive Care Medicine (ESICM) H1N1 registry. Results: Two hundred twenty patients admitted to an intensive care unit (ICU) with completed outcome data were analyzed. Invasive mechanical ventilation was used in 155 (70.5%). Sixty-seven (30.5%) of the patients died in ICU and 75 (34.1%) whilst in hospital. One hundred twenty-six (57.3%) patients received corticosteroid therapy on admission to ICU. Patients who received corticosteroids were significantly older and were more likely to have coexisting asthma, chronic obstructive pulmonary disease (COPD), and chronic steroid use. These patients receiving corticosteroids had increased likelihood of developing hospital-acquired pneumonia (HAP) [26.2% versus 13.8%, p < 0.05; odds ratio (OR) 2.2, confidence interval (CI) 1.1-4.5]. Patients who received corticosteroids had significantly higher ICU mortality than patients who did not (46.0% versus 18.1%, p < 0.01; OR 3.8, CI 2.1-7.2). Cox regression analysis adjusted for severity and potential confounding factors identified that early use of corticosteroids was not significantly associated with mortality [hazard ratio (HR) 1.3, 95% CI 0.7-2.4, p = 0.4] but was still associated with an increased rate of HAP (OR 2.2, 95% CI 1.0-4.8, p < 0.05). When only patients developing acute respiratory distress syndrome (ARDS) were analyzed, similar results were observed. Conclusions: Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection did not result in better outcomes and was associated with increased risk of superinfections. associated with mortality [hazard ratio (HR) 1.3, 95% CI 0.7-2.4, p = 0.4] but was still associated with an increased rate of HAP (OR 2.2, 95% CI 1.0-4.8, p < 0.05). When only patients developing acute respiratory distress syndrome (ARDS) were analyzed, similar results were observed. Conclusions: Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection did not result in better outcomes and was associated with increased risk of superinfections.

Original language	English
Pages (from-to)	272-283
Number of pages	12
Journal	Intensive Care Medicine
Volume	37
Issue number	2
DOIs	https://doi.org/10.1007/s00134-010-2078-z
Publication status	Published - Feb 2011

Other keywords

ARDS
Community acquired pneumonia
Corticosteroid therapy
Pandemic (H1N1)v influenza A infection

Access to Document

10.1007/s00134-010-2078-z

Cite this

Martin-Loeches, I., Lisboa, T., Rhodes, A., Moreno, R. P., Silva, E., Sprung, C., Chiche, J. D., Barahona, D., Villabon, M., Balasini, C., Pearse, R., Matos, R., Rello, J., Rodriguez, A., Capuzzo, M., Reina, R., Marsh, B., Flaaten, H., Sigurdsson, G., ... Bui, T. (2011). Use of early corticosteroid therapy on ICU admission in patients affected by severe pandemic (H1N1)v influenza A infection. Intensive Care Medicine, 37(2), 272-283. https://doi.org/10.1007/s00134-010-2078-z

@article{250acafcff0c41c2aa7846013f9fb5ed,

title = "Use of early corticosteroid therapy on ICU admission in patients affected by severe pandemic (H1N1)v influenza A infection",

abstract = "Introduction: Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection, although relatively common, remains controversial. Methods: Prospective, observational, multicenter study from 23 June 2009 through 11 February 2010, reported in the European Society of Intensive Care Medicine (ESICM) H1N1 registry. Results: Two hundred twenty patients admitted to an intensive care unit (ICU) with completed outcome data were analyzed. Invasive mechanical ventilation was used in 155 (70.5%). Sixty-seven (30.5%) of the patients died in ICU and 75 (34.1%) whilst in hospital. One hundred twenty-six (57.3%) patients received corticosteroid therapy on admission to ICU. Patients who received corticosteroids were significantly older and were more likely to have coexisting asthma, chronic obstructive pulmonary disease (COPD), and chronic steroid use. These patients receiving corticosteroids had increased likelihood of developing hospital-acquired pneumonia (HAP) [26.2% versus 13.8%, p < 0.05; odds ratio (OR) 2.2, confidence interval (CI) 1.1-4.5]. Patients who received corticosteroids had significantly higher ICU mortality than patients who did not (46.0% versus 18.1%, p < 0.01; OR 3.8, CI 2.1-7.2). Cox regression analysis adjusted for severity and potential confounding factors identified that early use of corticosteroids was not significantly associated with mortality [hazard ratio (HR) 1.3, 95% CI 0.7-2.4, p = 0.4] but was still associated with an increased rate of HAP (OR 2.2, 95% CI 1.0-4.8, p < 0.05). When only patients developing acute respiratory distress syndrome (ARDS) were analyzed, similar results were observed. Conclusions: Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection did not result in better outcomes and was associated with increased risk of superinfections. associated with mortality [hazard ratio (HR) 1.3, 95% CI 0.7-2.4, p = 0.4] but was still associated with an increased rate of HAP (OR 2.2, 95% CI 1.0-4.8, p < 0.05). When only patients developing acute respiratory distress syndrome (ARDS) were analyzed, similar results were observed. Conclusions: Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection did not result in better outcomes and was associated with increased risk of superinfections.",

keywords = "ARDS, Community acquired pneumonia, Corticosteroid therapy, Pandemic (H1N1)v influenza A infection",

author = "Ignacio Martin-Loeches and Thiago Lisboa and Andrew Rhodes and Moreno, {R. P.} and Eliezer Silva and C. Sprung and Chiche, {Jean Daniel} and Diego Barahona and Mario Villabon and Carina Balasini and Rupert Pearse and Ricardo Matos and Jordi Rello and Alejandro Rodriguez and Maurizia Capuzzo and Rosa Reina and Brian Marsh and Haans Flaaten and Gisli Sigurdsson and Zykova Ivana and Vladimir Cerny and Michael Quintel and Tobias Welte and Manuel Mayorga and Georges Offenstadt and Bertrand Guidet and Phillip Levin and Rothen, {Hans Ulrich} and Charles Gomersall and Hashemian, {Seyed Mohammadreza} and Constantine Katsanoulas and Heleni Mouloudi and Farhad Kapadia and Andreas Valentin and Goran Hedenstierna and Anders Perner and Guillermo Bugedo and Esko Ruokonen and Arandes, {Antoni Soriano} and Montejo, {Juan C.} and Ram{\'o}n Pe{\~n}{\'i}scola and Cecilia Hermosa and Federico Gordo and Jaime Latour and Loreto Vidaur and Manuel Alvarez-Gonzalez and Luis Alvarez-Rocha and {De Pablo}, Ana and Cristina Ferri and {De Arbina Martinez}, Lopez and Cort{\'e}s C{\^a}nones and Josu Insausti and Jose Cambronero and Beatriz Galvan and Jos{\'e} Luna and Rafael Blancas and Carmen Garcia and Rafael Sierra and Dorado, {Francisco Fern{\'a}ndez} and Pablo Monedero and Jose Llagunes and Pedro Cobo and Antonia Socias and Rafael Leon-Lopez and Elisabeth Esteban and Marquina Lacueva and Monica Magret and {Del Nogal}, Frutos and Alexandra Dinis and Anabela B{\'a}rtolo and Armindo Ramos and Carlos Franca and Celso Estevens and Cristina Granja and Cust{\'o}dio Fidalgo and Eduardo Almeida and Estev{\~a}o Lafuente and Fernando Rua and Francisco Esteves and Jos{\'e} Clemente and N{\'o}brega, {Jos{\'e} J{\'u}lio} and Pereira, {Jos{\'e} Manuel} and Moura, {Jos{\'e} Pedro} and {Trindade E Silva}, {Lu{\'i}s Paulo} and Lu{\'i}s Telo and Lurdes Santos and Pedrosa, {Maria Jos{\'e}} and Maria Oliveira and Margarida Resende and Nuno Catorze and Paula Coutinho and Rosa Ribeiro and Rui Moreno and Isabel Miranda and Teresa Cardoso and V{\'i}tor Branco and Giacomo Bellani and Ros Urbino and Adriano Peris and Alessandro Amatu and Giorgio Berlot and Marzani, {Federico Capra} and Ulisse Corbanese and Antonio David and Paolo Chiarandini and Corte, {Francesco Della} and Caspani, {Maria Luisa} and Conio Alessandra and Valerio Mangani and Romano Tetamo and Andrea Wolfler and Giuseppe Tappat{\`a} and Vivaldi Nicoletta and Guido Bertolini and Lorella Pelagalli and Alexandre Molin and Massimo Girardis and Giuseppe Gristin and Ammy Lam and Ian Crabb and Rebecca Cusack and Rhiannon Jackson and Chithambaram Veerappan and Craig Whiteley and Tony Ware and Stephan Krueper and Caleb Mckinstry and Andrew Ferguson and Francesca Rubulotta and Erick Valencia and Susana Gonzalez and Victor Cevallos and Alan Zazu and Fresco, {Jeronimo Nahuel Chaparro} and Gabriel Galindez and Cecilia Barrios and Carlos Lovesio and Boris Villamagua and Mario Cadena and Estuardo Salgado and Garc{\'i}a, {Mari{\`a} Fernanda} and Gustavo Paredes and Maria Donnelly and Donall O'Croinin and John Bates and Niall Kavanagh and Brian O'Brien and Rob Plant and Michael Scully and Rachel Farragher and Louise Oliveira and Sergio Mataloun and Dantas, {Vicente Souza} and Luiz Simvoulidis and P{\'e}ricles Duarte and Cintia Grion and Almir Germano and Laake, {Jon Henrik} and Elin Helset and Dagny Klausen and Hans Flaatten and Kari Bruheim and Bjarki Kristinsson and Sigurdsson, {Sigurdur E.} and Jan Hrub{\'y} and Radka Valkova and Robert Janda and Ivana Zykova and Andrea Kernchen and Frank Bloos and Simone Rosseau and Jens Krassler and Frank Fischer and Abel Arroyo-Sanchez and Poquet, {Alejandro Barrionuevo} and Palomino, {Ivan Ramos} and Fabiola Rafael and Juan Salasfoch and Gregory Dubar and Tonnelier, {Jean Marie} and Saber Barbar and Murielle Dobrzynski and Alexandre Mignon and Daniel Jakobson and Moti Klein and Eran Segal and Yaron Barlavie and Moshe Hersch and Salom{\'o}n, {Zule Sicardi} and Herv{\'e} Zender and Rothen, {Hans U.} and Kenny Chan and Tom Buckley and Uros Batranovic and Ilons Schaffer and Jelena Sretkovic and Despoina Koulenti and Eleni Mouloudi and Clouva-Molyvdas, {Phyllis Maria} and Mohan Gurjar and Deepak Vijayan and Georg Hinterholzer and Alexander Kulier and Carin Verlaat and Dirk Ebel and Johan Persson and Sten Walther and Per Petersen and Walter Swinnen and Vincent Collin and Hanne Olsen and Patricio Gutierrez and Guillaume Thiery and Heikki Laine and Arvydas Rumba and Sundaresan Maiyalagan and Thinh Bui",

year = "2011",

month = feb,

doi = "10.1007/s00134-010-2078-z",

language = "English",

volume = "37",

pages = "272--283",

journal = "Intensive Care Medicine",

issn = "0342-4642",

publisher = "Springer Verlag",

number = "2",

}

Martin-Loeches, I, Lisboa, T, Rhodes, A, Moreno, RP, Silva, E, Sprung, C, Chiche, JD, Barahona, D, Villabon, M, Balasini, C, Pearse, R, Matos, R, Rello, J, Rodriguez, A, Capuzzo, M, Reina, R, Marsh, B, Flaaten, H, Sigurdsson, G, Ivana, Z, Cerny, V, Quintel, M, Welte, T, Mayorga, M, Offenstadt, G, Guidet, B, Levin, P, Rothen, HU, Gomersall, C, Hashemian, SM, Katsanoulas, C, Mouloudi, H, Kapadia, F, Valentin, A, Hedenstierna, G, Perner, A, Bugedo, G, Ruokonen, E, Arandes, AS, Montejo, JC, Peñíscola, R, Hermosa, C, Gordo, F, Latour, J, Vidaur, L, Alvarez-Gonzalez, M, Alvarez-Rocha, L, De Pablo, A, Ferri, C, De Arbina Martinez, L, Cânones, C, Insausti, J, Cambronero, J, Galvan, B, Luna, J, Blancas, R, Garcia, C, Sierra, R, Dorado, FF, Monedero, P, Llagunes, J, Cobo, P, Socias, A, Leon-Lopez, R, Esteban, E, Lacueva, M, Magret, M, Del Nogal, F, Dinis, A, Bártolo, A, Ramos, A, Franca, C, Estevens, C, Granja, C, Fidalgo, C, Almeida, E, Lafuente, E, Rua, F, Esteves, F, Clemente, J, Nóbrega, JJ, Pereira, JM, Moura, JP, Trindade E Silva, LP, Telo, L, Santos, L, Pedrosa, MJ, Oliveira, M, Resende, M, Catorze, N, Coutinho, P, Ribeiro, R, Moreno, R, Miranda, I, Cardoso, T, Branco, V, Bellani, G, Urbino, R, Peris, A, Amatu, A, Berlot, G, Marzani, FC, Corbanese, U, David, A, Chiarandini, P, Corte, FD, Caspani, ML, Alessandra, C, Mangani, V, Tetamo, R, Wolfler, A, Tappatà, G, Nicoletta, V, Bertolini, G, Pelagalli, L, Molin, A, Girardis, M, Gristin, G, Lam, A, Crabb, I, Cusack, R, Jackson, R, Veerappan, C, Whiteley, C, Ware, T, Krueper, S, Mckinstry, C, Ferguson, A, Rubulotta, F, Valencia, E, Gonzalez, S, Cevallos, V, Zazu, A, Fresco, JNC, Galindez, G, Barrios, C, Lovesio, C, Villamagua, B, Cadena, M, Salgado, E, García, MF, Paredes, G, Donnelly, M, O'Croinin, D, Bates, J, Kavanagh, N, O'Brien, B, Plant, R, Scully, M, Farragher, R, Oliveira, L, Mataloun, S, Dantas, VS, Simvoulidis, L, Duarte, P, Grion, C, Germano, A, Laake, JH, Helset, E, Klausen, D, Flaatten, H, Bruheim, K, Kristinsson, B, Sigurdsson, SE, Hrubý, J, Valkova, R, Janda, R, Zykova, I, Kernchen, A, Bloos, F, Rosseau, S, Krassler, J, Fischer, F, Arroyo-Sanchez, A, Poquet, AB, Palomino, IR, Rafael, F, Salasfoch, J, Dubar, G, Tonnelier, JM, Barbar, S, Dobrzynski, M, Mignon, A, Jakobson, D, Klein, M, Segal, E, Barlavie, Y, Hersch, M, Salomón, ZS, Zender, H, Rothen, HU, Chan, K, Buckley, T, Batranovic, U, Schaffer, I, Sretkovic, J, Koulenti, D, Mouloudi, E, Clouva-Molyvdas, PM, Gurjar, M, Vijayan, D, Hinterholzer, G, Kulier, A, Verlaat, C, Ebel, D, Persson, J, Walther, S, Petersen, P, Swinnen, W, Collin, V, Olsen, H, Gutierrez, P, Thiery, G, Laine, H, Rumba, A, Maiyalagan, S & Bui, T 2011, 'Use of early corticosteroid therapy on ICU admission in patients affected by severe pandemic (H1N1)v influenza A infection', Intensive Care Medicine, vol. 37, no. 2, pp. 272-283. https://doi.org/10.1007/s00134-010-2078-z

TY - JOUR

T1 - Use of early corticosteroid therapy on ICU admission in patients affected by severe pandemic (H1N1)v influenza A infection

AU - Martin-Loeches, Ignacio

AU - Lisboa, Thiago

AU - Rhodes, Andrew

AU - Moreno, R. P.

AU - Silva, Eliezer

AU - Sprung, C.

AU - Chiche, Jean Daniel

AU - Barahona, Diego

AU - Villabon, Mario

AU - Balasini, Carina

AU - Pearse, Rupert

AU - Matos, Ricardo

AU - Rello, Jordi

AU - Rodriguez, Alejandro

AU - Capuzzo, Maurizia

AU - Reina, Rosa

AU - Marsh, Brian

AU - Flaaten, Haans

AU - Sigurdsson, Gisli

AU - Ivana, Zykova

AU - Cerny, Vladimir

AU - Quintel, Michael

AU - Welte, Tobias

AU - Mayorga, Manuel

AU - Offenstadt, Georges

AU - Guidet, Bertrand

AU - Levin, Phillip

AU - Rothen, Hans Ulrich

AU - Gomersall, Charles

AU - Hashemian, Seyed Mohammadreza

AU - Katsanoulas, Constantine

AU - Mouloudi, Heleni

AU - Kapadia, Farhad

AU - Valentin, Andreas

AU - Hedenstierna, Goran

AU - Perner, Anders

AU - Bugedo, Guillermo

AU - Ruokonen, Esko

AU - Arandes, Antoni Soriano

AU - Montejo, Juan C.

AU - Peñíscola, Ramón

AU - Hermosa, Cecilia

AU - Gordo, Federico

AU - Latour, Jaime

AU - Vidaur, Loreto

AU - Alvarez-Gonzalez, Manuel

AU - Alvarez-Rocha, Luis

AU - De Pablo, Ana

AU - Ferri, Cristina

AU - De Arbina Martinez, Lopez

AU - Cânones, Cortés

AU - Insausti, Josu

AU - Cambronero, Jose

AU - Galvan, Beatriz

AU - Luna, José

AU - Blancas, Rafael

AU - Garcia, Carmen

AU - Sierra, Rafael

AU - Dorado, Francisco Fernández

AU - Monedero, Pablo

AU - Llagunes, Jose

AU - Cobo, Pedro

AU - Socias, Antonia

AU - Leon-Lopez, Rafael

AU - Esteban, Elisabeth

AU - Lacueva, Marquina

AU - Magret, Monica

AU - Del Nogal, Frutos

AU - Dinis, Alexandra

AU - Bártolo, Anabela

AU - Ramos, Armindo

AU - Franca, Carlos

AU - Estevens, Celso

AU - Granja, Cristina

AU - Fidalgo, Custódio

AU - Almeida, Eduardo

AU - Lafuente, Estevão

AU - Rua, Fernando

AU - Esteves, Francisco

AU - Clemente, José

AU - Nóbrega, José Júlio

AU - Pereira, José Manuel

AU - Moura, José Pedro

AU - Trindade E Silva, Luís Paulo

AU - Telo, Luís

AU - Santos, Lurdes

AU - Pedrosa, Maria José

AU - Oliveira, Maria

AU - Resende, Margarida

AU - Catorze, Nuno

AU - Coutinho, Paula

AU - Ribeiro, Rosa

AU - Moreno, Rui

AU - Miranda, Isabel

AU - Cardoso, Teresa

AU - Branco, Vítor

AU - Bellani, Giacomo

AU - Urbino, Ros

AU - Peris, Adriano

AU - Amatu, Alessandro

AU - Berlot, Giorgio

AU - Marzani, Federico Capra

AU - Corbanese, Ulisse

AU - David, Antonio

AU - Chiarandini, Paolo

AU - Corte, Francesco Della

AU - Caspani, Maria Luisa

AU - Alessandra, Conio

AU - Mangani, Valerio

AU - Tetamo, Romano

AU - Wolfler, Andrea

AU - Tappatà, Giuseppe

AU - Nicoletta, Vivaldi

AU - Bertolini, Guido

AU - Pelagalli, Lorella

AU - Molin, Alexandre

AU - Girardis, Massimo

AU - Gristin, Giuseppe

AU - Lam, Ammy

AU - Crabb, Ian

AU - Cusack, Rebecca

AU - Jackson, Rhiannon

AU - Veerappan, Chithambaram

AU - Whiteley, Craig

AU - Ware, Tony

AU - Krueper, Stephan

AU - Mckinstry, Caleb

AU - Ferguson, Andrew

AU - Rubulotta, Francesca

AU - Valencia, Erick

AU - Gonzalez, Susana

AU - Cevallos, Victor

AU - Zazu, Alan

AU - Fresco, Jeronimo Nahuel Chaparro

AU - Galindez, Gabriel

AU - Barrios, Cecilia

AU - Lovesio, Carlos

AU - Villamagua, Boris

AU - Cadena, Mario

AU - Salgado, Estuardo

AU - García, Marià Fernanda

AU - Paredes, Gustavo

AU - Donnelly, Maria

AU - O'Croinin, Donall

AU - Bates, John

AU - Kavanagh, Niall

AU - O'Brien, Brian

AU - Plant, Rob

AU - Scully, Michael

AU - Farragher, Rachel

AU - Oliveira, Louise

AU - Mataloun, Sergio

AU - Dantas, Vicente Souza

AU - Simvoulidis, Luiz

AU - Duarte, Péricles

AU - Grion, Cintia

AU - Germano, Almir

AU - Laake, Jon Henrik

AU - Helset, Elin

AU - Klausen, Dagny

AU - Flaatten, Hans

AU - Bruheim, Kari

AU - Kristinsson, Bjarki

AU - Sigurdsson, Sigurdur E.

AU - Hrubý, Jan

AU - Valkova, Radka

AU - Janda, Robert

AU - Zykova, Ivana

AU - Kernchen, Andrea

AU - Bloos, Frank

AU - Rosseau, Simone

AU - Krassler, Jens

AU - Fischer, Frank

AU - Arroyo-Sanchez, Abel

AU - Poquet, Alejandro Barrionuevo

AU - Palomino, Ivan Ramos

AU - Rafael, Fabiola

AU - Salasfoch, Juan

AU - Dubar, Gregory

AU - Tonnelier, Jean Marie

AU - Barbar, Saber

AU - Dobrzynski, Murielle

AU - Mignon, Alexandre

AU - Jakobson, Daniel

AU - Klein, Moti

AU - Segal, Eran

AU - Barlavie, Yaron

AU - Hersch, Moshe

AU - Salomón, Zule Sicardi

AU - Zender, Hervé

AU - Rothen, Hans U.

AU - Chan, Kenny

AU - Buckley, Tom

AU - Batranovic, Uros

AU - Schaffer, Ilons

AU - Sretkovic, Jelena

AU - Koulenti, Despoina

AU - Mouloudi, Eleni

AU - Clouva-Molyvdas, Phyllis Maria

AU - Gurjar, Mohan

AU - Vijayan, Deepak

AU - Hinterholzer, Georg

AU - Kulier, Alexander

AU - Verlaat, Carin

AU - Ebel, Dirk

AU - Persson, Johan

AU - Walther, Sten

AU - Petersen, Per

AU - Swinnen, Walter

AU - Collin, Vincent

AU - Olsen, Hanne

AU - Gutierrez, Patricio

AU - Thiery, Guillaume

AU - Laine, Heikki

AU - Rumba, Arvydas

AU - Maiyalagan, Sundaresan

AU - Bui, Thinh

PY - 2011/2

Y1 - 2011/2

N2 - Introduction: Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection, although relatively common, remains controversial. Methods: Prospective, observational, multicenter study from 23 June 2009 through 11 February 2010, reported in the European Society of Intensive Care Medicine (ESICM) H1N1 registry. Results: Two hundred twenty patients admitted to an intensive care unit (ICU) with completed outcome data were analyzed. Invasive mechanical ventilation was used in 155 (70.5%). Sixty-seven (30.5%) of the patients died in ICU and 75 (34.1%) whilst in hospital. One hundred twenty-six (57.3%) patients received corticosteroid therapy on admission to ICU. Patients who received corticosteroids were significantly older and were more likely to have coexisting asthma, chronic obstructive pulmonary disease (COPD), and chronic steroid use. These patients receiving corticosteroids had increased likelihood of developing hospital-acquired pneumonia (HAP) [26.2% versus 13.8%, p < 0.05; odds ratio (OR) 2.2, confidence interval (CI) 1.1-4.5]. Patients who received corticosteroids had significantly higher ICU mortality than patients who did not (46.0% versus 18.1%, p < 0.01; OR 3.8, CI 2.1-7.2). Cox regression analysis adjusted for severity and potential confounding factors identified that early use of corticosteroids was not significantly associated with mortality [hazard ratio (HR) 1.3, 95% CI 0.7-2.4, p = 0.4] but was still associated with an increased rate of HAP (OR 2.2, 95% CI 1.0-4.8, p < 0.05). When only patients developing acute respiratory distress syndrome (ARDS) were analyzed, similar results were observed. Conclusions: Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection did not result in better outcomes and was associated with increased risk of superinfections. associated with mortality [hazard ratio (HR) 1.3, 95% CI 0.7-2.4, p = 0.4] but was still associated with an increased rate of HAP (OR 2.2, 95% CI 1.0-4.8, p < 0.05). When only patients developing acute respiratory distress syndrome (ARDS) were analyzed, similar results were observed. Conclusions: Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection did not result in better outcomes and was associated with increased risk of superinfections.

AB - Introduction: Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection, although relatively common, remains controversial. Methods: Prospective, observational, multicenter study from 23 June 2009 through 11 February 2010, reported in the European Society of Intensive Care Medicine (ESICM) H1N1 registry. Results: Two hundred twenty patients admitted to an intensive care unit (ICU) with completed outcome data were analyzed. Invasive mechanical ventilation was used in 155 (70.5%). Sixty-seven (30.5%) of the patients died in ICU and 75 (34.1%) whilst in hospital. One hundred twenty-six (57.3%) patients received corticosteroid therapy on admission to ICU. Patients who received corticosteroids were significantly older and were more likely to have coexisting asthma, chronic obstructive pulmonary disease (COPD), and chronic steroid use. These patients receiving corticosteroids had increased likelihood of developing hospital-acquired pneumonia (HAP) [26.2% versus 13.8%, p < 0.05; odds ratio (OR) 2.2, confidence interval (CI) 1.1-4.5]. Patients who received corticosteroids had significantly higher ICU mortality than patients who did not (46.0% versus 18.1%, p < 0.01; OR 3.8, CI 2.1-7.2). Cox regression analysis adjusted for severity and potential confounding factors identified that early use of corticosteroids was not significantly associated with mortality [hazard ratio (HR) 1.3, 95% CI 0.7-2.4, p = 0.4] but was still associated with an increased rate of HAP (OR 2.2, 95% CI 1.0-4.8, p < 0.05). When only patients developing acute respiratory distress syndrome (ARDS) were analyzed, similar results were observed. Conclusions: Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection did not result in better outcomes and was associated with increased risk of superinfections. associated with mortality [hazard ratio (HR) 1.3, 95% CI 0.7-2.4, p = 0.4] but was still associated with an increased rate of HAP (OR 2.2, 95% CI 1.0-4.8, p < 0.05). When only patients developing acute respiratory distress syndrome (ARDS) were analyzed, similar results were observed. Conclusions: Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection did not result in better outcomes and was associated with increased risk of superinfections.

KW - ARDS

KW - Community acquired pneumonia

KW - Corticosteroid therapy

KW - Pandemic (H1N1)v influenza A infection

UR - http://www.scopus.com/inward/record.url?scp=79953816521&partnerID=8YFLogxK

U2 - 10.1007/s00134-010-2078-z

DO - 10.1007/s00134-010-2078-z

M3 - Article

C2 - 21107529

AN - SCOPUS:79953816521

SN - 0342-4642

VL - 37

SP - 272

EP - 283

JO - Intensive Care Medicine

JF - Intensive Care Medicine

IS - 2

ER -

Use of early corticosteroid therapy on ICU admission in patients affected by severe pandemic (H1N1)v influenza A infection

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