Pandemic (H1N1) 2009 influenza: experience from the critical care unit

This case series details experience of critical care admissions with pandemic (H1N1) 2009 influenza from an intensive care unit in the West Midlands. We present four critically ill patients admitted with severe hypoxia. Two of the patients failed a trial of continuous positive airway pressure and all underwent controlled ventilation within 24 h of admission. Bilevel and high frequency oscillatory ventilation were the most useful modes. Our patients generally had one organ failure and were ventilator dependent for relatively short periods of time. Three of the patients made a full recovery and one required ongoing dialysis. We also discuss service planning and our response to the pandemic. We were well prepared with stocks of personal protective equipment but had to modify plans as the outbreak progressed. Our cases and discussion provide useful information for other intensive care units preparing for the predicted autumn surge of H1N1 cases.