ICU docs call for bucks for studies of severe flu patients

[Guest guest]

Study worst cases of flu, group urges

Tom Blackwell, National Post Published: Monday, November 09, 2009

More money is urgently needed to study people made dangerously ill by the H1N1

flu -- even if they account for only a small fraction of pandemic patients, say

critical-care physicians who complain their key field has been chronically

starved of research funds.

The doctors who preside over intensive-care units (ICUs) and fight to save the

sickest of influenza sufferers say they managed to cobble together a partial

network of Canadian hospitals earlier this summer to track the characteristics

of severe flu patients. The resulting study, published in a major American

journal last month, was viewed around the world as ground-breaking, but it was

done without any federal funding, they say.

Intensive-care medicine has generally attracted relatively little research grant

money, despite the fact it accounts for a huge proportion of health care

spending -- estimated by some at 1% of Canada's gross domestic product, the ICU

doctors say.

" The intensive care unit is often kind of the harbinger for any kind of severe

illness in the community, because the sickest patients end up being cared for in

the ICU, " said Dr. Marshall, head of the Canadian critical care trials

group. " We are in a sense the canary in the coal mine. "

Stepped-up study efforts might help solve the disturbing mystery of why a small

number of relatively healthy young people are made so ill by H1N1 -- probably a

matter of genetics --and uncover new ways to treat them, he said.

The Canadian Institute for Health Research and the Public Health Agency of

Canada recently offered critical-care medicine some funding for H1N1 study. Dr.

-, head of the agency, said in an interview this week that

additional research in the area is important.

Millions more is needed, though, to set up a system involving all ICUs in the

country to record and share basic information on each of their patients, said

Dr. Rob Fowler, critical-care physician at Toronto's Sunnybrook Health Sciences

Centre.

The Ontario government funded such a project earlier this year and it is proving

invaluable, he said.

" If you're in the business of preventing people from dying from H1N1, then you

are the people you need to focus on, " said Dr. Fowler.

The intensivists' pleas underline, though, what some see as a subtle tension in

pandemic-flu medicine between the infectious-disease specialists who encounter a

wide range of patients and often focus on prevention, and critical-care doctors

who treat only the most ill.

The infection experts have been more apt to remind Canadians that the vast

majority of pandemic-flu patients endure only mild illness; the critical-care

doctors have spoken out about the desperately ill minority.

" Never was there a group that so longed to make themselves seem more important

than everyone else than critical care medicine, " quipped one communicable

disease specialist earlier this month. " For them, all the world is a tragedy.

But you have to be careful when you talk to the general public not to scare

them. "

http://www.nationalpost.com/news/canada/story.html?id=2200768