Nutrition and functional outcomes after critical illness due to pandemic (H1N1) 2009 influenza: a retrospective cohort study.

Objective: To determine functional outcomes 6 months after intensive care unit admission for severe infection due to pandemic (H1N1) 2009 influenza and examine the relationship between nutrition during ICU admission and outcome.

Design, Setting And Participants: Retrospective cohort study of patients with confirmed H1N1 influenza admitted to the ICU, Royal Adelaide Hospital, South Australia, June- October 2009.

Main Outcome Measures: Data were collected from medical records, dietitian notes and the daily ICU chart and included: demographics, daily kilocalories (Kcal) and protein delivered compared with dietitian-calculated requirement, ICU and hospital length of stay. Weight change and functional outcome at 6 months were determined prospectively by telephone interview using the 12-Item Short Form Health Survey and the EuroQol Group 5-Dimension Questionnaire.

Results: Of 25 patients with H1N1 infection, 23 were included in the study (14 men; median age, 48 years (interquartile range [IQR], 39-55 years); median Acute Physiology and Chronic Health Evaluation (APACHE) II score, 17 (IQR, 13-21); median ICU length of stay, 9 days (IQR, 4-15 days); median hospital length of stay, 20 days (IQR, 11-30 days); ICU mortality, 3 (13%; 95% CI, 4%- 33%). Enteral feeding was commenced in 16 patients, who received a mean of 71% (SD, 27%; 95% CI, 57%-86%) of their energy and 62% (SD, 25%; 95% CI, 49%-75%) of their protein goals over their ICU stay. A more negative protein balance was associated with prolonged ICU stay (r = - 0.746; P = 0.003). Reduced success of feeding was associated with increased severity of illness and shorter ICU length of stay. Patients reported a good functional outcome at 6 months.

Conclusions: Patients admitted to this ICU with H1N1 infection were fed successfully during their stay. Critically ill patients surviving H1N1 infection had good functional outcomes at 6 months.