• M C Beumer, R M Koch, D van Beuningen, A M OudeLashof, F L van de Veerdonk, E Kolwijck, J G van der Hoeven, D C Bergmans, and Hoedemaekers C W E CWE Radboud University Medical Center, Department of Intensive Care Medicine, PO Box 9101, 6500 HB Nijmegen, the Netherlands..
• Radboud University Medical Center, Department of Intensive Care Medicine, PO Box 9101, 6500 HB Nijmegen, the Netherlands.
• J Crit Care. 2019 Apr 1; 50: 59-65.

PurposeWhile most influenza patients have a self-limited respiratory illness, 5-10% of hospitalized patients develop severe disease requiring ICU admission. The aim of this study was to identify influenza-specific factors associated with ICU admission and mortality. Furthermore, influenza-specific pulmonary bacterial, fungal and viral co-infections were investigated.Methods199 influenza patients, admitted to two academic hospitals in the Netherlands between 01-10-2015 and 01-04-2016 were investigated of which 45/199 were admitted to the ICU.ResultsA history of Obstructive/Central Sleep Apnea Syndrome, myocardial infarction, dyspnea, influenza type A, BMI > 30, the development of renal failure and bacterial and fungal co-infections, were observed more frequently in patients who were admitted to the ICU, compared with patients at the normal ward. Co-infections were evident in 55.6% of ICU-admitted patients, compared with 20.1% of patients at the normal ward, mainly caused by Staphylococcus aureus, Streptococcus pneumoniae, and Aspergillus fumigatus. Non-survivors suffered from diabetes mellitus and (pre-existent) renal failure more often.ConclusionsThe current study indicates that a history of OSAS/CSAS, myocardial infarction and BMI > 30 might be related to ICU admission in influenza patients. Second, ICU patients develop more pulmonary co-infections. Last, (pre-existent) renal failure and diabetes mellitus are more often observed in non-survivors.Copyright © 2018 Elsevier Inc. All rights reserved.

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