Interest of a simple on-line screening registry for measuring ICU burden related to an Influenza pandemic.

Jean-Christophe Marie Richard (1, 2, 3) , Tài Pham (4) , Christian Brun-Buisson (4, 5) , Jean Reignier (6) , Alain Mercat (7, 8) , Gaëtan Beduneau (1, 3) , Bernard Régnier (9) , Bruno Mourvillier (9) , Christophe Guitton (10) , Matthias Castanier (11) , Alain Combes (12) , Yves Le Tulzo (13, 14) , Laurent Brochard (2)

1 Service de Réanimation Médicale [CHU Rouen]
2 Department of Intensive Care
3 GRHV - Groupe de Recherche sur le Handicap Ventilatoire
4 Service de réanimation médicale
5 IMRB - Institut Mondor de Recherche Biomédicale
6 Service de Réanimation Polyvalente
7 Service de Réanimation Médicale et de médecine hyperbare
8 LUNAM Université [Nantes Angers Le Mans]
9 Service de réanimation médicale et infectieuse
10 Service de Réanimation Médicale
11 Service de Réanimation, détresses respiratoires et infections sévères
12 CHU Pitié-Salpêtrière [AP-HP]
13 Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes]
14 CIC - Centre d'Investigation Clinique [Rennes]

ABSTRACT: INTRODUCTION: The specific burden imposed on Intensive Care Units (ICUs) during the A/H1N1 influenza 2009 pandemic has been poorly explored. An on-line screening registry allowed a daily report of ICU beds occupancy rate by flu infected patients (Flu-OR) admitted in French ICUs. METHODS: A prospective inception cohort study with results of an on-line screening registry designed for daily assessment of ICU burden. RESULTS: Among the 108 centers participating to the French H1N1 research network on mechanical ventilation (REVA) - French Society of Intensive Care (SRLF) registry, 69 ICUs belonging to seven large geographical areas voluntarily participated to a website screening-registry. The aim was to daily assess the ICU beds occupancy rate by influenza-infected and non-infected patients for at least three weeks. 391 critically ill infected patients were enrolled in the cohort, representing a subset of 35% of the whole French 2009 pandemic cohort; 73% were mechanically ventilated, 13% required extra corporal membrane oxygenation (ECMO) and 22% died. The global Flu-OR in these ICUs was only 7.6%, but it exceeded a predefined 15% critical threshold in 32 ICUs for a total of 103 weeks. Flu-ORs were significantly higher in University than in non University hospitals. The peak ICU burden was poorly predicted by observations obtained at the level of large geographical areas. CONCLUSIONS: The peak Flu-OR during the pandemic significantly exceeded a 15% critical threshold in almost half of the ICUs, with an uneven distribution with time, geographical areas and between University and non University hospitals. An on-line assessment of Flu-OR via a simple dedicated registry may contribute to better match resources and needs.

Domaines: Maladies infectieuses

Jean-Christophe Marie Richard, Tài Pham, Christian Brun-Buisson, Jean Reignier, Alain Mercat, et al.. Interest of a simple on-line screening registry for measuring ICU burden related to an Influenza pandemic.. Critical Care, 2012, 16 (4), pp.R118. ⟨10.1186/cc11412⟩. ⟨inserm-00723061⟩