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

Jean-Christophe 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 Tulzo 13, 14 Laurent Brochard 2
* Auteur correspondant
1 Service de réanimation médicale [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
9 Service de réanimation médicale et infectieuse
10 Service de Réanimation Médicale
11 Service de Réanimation, détresses respiratoires et infections sévères
12 Service de Réanimation Médicale [CHU Pitié-Salpétrière]
13 Service de Maladies Infectieuses et Réanimation médicale
14 CIC - Centre d'Investigation Clinique [Rennes]
Abstract : 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.
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Critical Care, BioMed Central, 2012, 16 (4), pp.R118. 〈10.1186/cc11412〉
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Jean-Christophe 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, BioMed Central, 2012, 16 (4), pp.R118. 〈10.1186/cc11412〉. 〈inserm-00723061〉

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