%0 Journal Article
%T Recomendaciones del Grupo de Trabajo Enfermedades Infecciosas (GTEI) de la Sociedad Espa£¿ola de Medicina Intensiva, Cr¨ªtica y Unidades Coronarias (SEMICYUC) y el Grupo de Estudio de Infecciones en el Paciente Cr¨ªtico (GEIPC) de la Sociedad Espa£¿ola de Enfermedades Infecciosas y Microbiolog¨ªa cl¨ªnica (SEIMC) para el diagn¨®stico y tratamiento de la gripe A/H1N1 en pacientes adultos graves hospitalizados en las Unidades de Cuidados Intensivos
%A Rodr¨ªguez
%A A.
%A ¨¢lvarez-Rocha
%A L.
%A Sirvent
%A J.M.
%A Zaragoza
%A R.
%A Nieto
%A M.
%A Arenzana
%A A.
%A Luque
%A P.
%A Soc¨ªas
%A L.
%A Mart¨ªn
%A M.
%A Navarro
%A D.
%A Camarena
%A J.
%A Lorente
%A L.
%A Trefler
%A S.
%A Vidaur
%A L.
%A Sol¨¦-Viol¨¢n
%A J.
%A Barcenilla
%A F.
%A Pobo
%A A.
%A Vall¨¦s
%A J.
%A Ferri
%A C.
%A Mart¨ªn-Loeches
%A I.
%A D¨ªaz
%A E.
%A L¨®pez
%A D.
%A L¨®pez-Pueyo
%A M.J.
%A Gordo
%A F.
%A Nogal
%A F. del
%A Marqu¨¦s
%A A.
%A Tormo
%A S.
%A Fuset
%A M.P.
%A P¨¦rez
%A F.
%A Bonastre
%A J.
%A Suberviola
%A B.
%A Navas
%A E.
%A Le¨®n
%A C.
%A 
%J Medicina Intensiva
%D 2012
%I Ediciones Doyma, S.L.
%X the diagnosis of influenza a/h1n1 is mainly clinical, particularly during peak or seasonal flu outbreaks. a diagnostic test should be performed in all patients with fever and flu symptoms that require hospitalization. the respiratory sample (nasal or pharyngeal exudate or deeper sample in intubated patients) should be obtained as soon as possible, with the immediate start of empirical antiviral treatment. molecular methods based on nucleic acid amplification techniques (rt-pcr) are the gold standard for the diagnosis of influenza a/h1n1. immunochromatographic methods have low sensitivity; a negative result therefore does not rule out active infection. classical culture is slow and has low sensitivity. direct immunofluorescence offers a sensitivity of 90%, but requires a sample of high quality. indirect methods for detecting antibodies are only of epidemiological interest. patients with a/h1n1 flu may have relative leukopenia and elevated serum levels of ldh, cpk and crp, but none of these variables are independently associated to the prognosis. however, plasma ldh> 1500 iu/l, and the presence of thrombocytopenia <150x109/l, could define a patient population at risk of suffering serious complications. antiviral administration (oseltamivir) should start early (<48h from the onset of symptoms), with a dose of 75mg every 12h, and with a duration of at least 7 days or until clinical improvement is observed. early antiviral administration is associated to improved survival in critically ill patients. new antiviral drugs, especially those formulated for intravenous administration, may be the best choice in future epidemics. patients with a high suspicion of influenza a/h1n1 infection must continue with antiviral treatment, regardless of the negative results of initial tests, unless an alternative diagnosis can be established or clinical criteria suggest a low probability of influenza. in patients with influenza a/h1n1 pneumonia, empirical antibiotic therapy should be provi
%K influenza a/h1n1
%K gold standard
%K acute respiratory distress syndrome.
%U http://scielo.isciii.es/scielo.php?script=sci_abstract&pid=S0210-56912012000200006&lng=en&nrm=iso&tlng=en