PT  - JOURNAL ARTICLE
AU  - S.M. Brown
AU  - J. Pittman
AU  - R.R. Miller III
AU  - K.D. Horton
AU  - B. Markewitz
AU  - E. Hirshberg
AU  - J. Jones
AU  - C.K. Grissom
TI  - Right and left heart failure in severe H1N1 influenza A infection
AID  - 10.1183/09031936.00008210
DP  - 2011 Jan 01
TA  - European Respiratory Journal
PG  - 112--118
VI  - 37
IP  - 1
4099  - http://erj.ersjournals.com/content/37/1/112.short
4100  - http://erj.ersjournals.com/content/37/1/112.full
SO  - Eur Respir J2011 Jan 01; 37
AB  - Influenza infection can affect cardiac function. The recent pandemic of H1N1 influenza A provided an opportunity to study echocardiographic findings in critically ill infected patients.We hypothesised that critically ill patients with H1N1 infection would have a higher incidence of right and left heart failure than is seen in unselected populations of patients with septic shock and/or acute respiratory distress syndrome (ARDS).We retrospectively studied all patients admitted to four intensive care units at three hospitals in Salt Lake County, UT, USA, with laboratory-confirmed H1N1 infection in whom a clinical echocardiogram was available.23 out of 48 patients had qualifying echocardiograms. Right ventricular (RV) dilatation (50–80%) and at least moderate systolic impairment (23%) were common, higher than the range described in general populations with ARDS. Left ventricular systolic dysfunction was present in 17% of patients. No single echocardiographic parameter was associated with 28-day mortality or ventilator-free days to 28 days.Critically ill patients with H1N1 infection frequently exhibit right heart dilatation and failure. RV basal dilatation was extremely common. These patients have less left heart failure than expected on the basis of prior descriptions of influenza myopericarditis or of general populations of septic patients.