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Erschienen in: Intensive Care Medicine 6/2010

01.06.2010 | Pediatric Original

Critically ill infants and children with influenza A (H1N1) in pediatric intensive care units in Argentina

verfasst von: Julio A. Farias, Analía Fernández, Ezequiel Monteverde, Nilda Vidal, Pilar Arias, María J. Montes, Gabriela Rodríguez, Mariela Allasia, Maria E. Ratto, Roxana Jaén, Claudia Meregalli, Karina Fiquepron, Ana R. Calvo, Alejandro Siaba, Lidia Albano, Rossana Poterala, Pablo Neira, Andrés Esteban

Erschienen in: Intensive Care Medicine | Ausgabe 6/2010

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Abstract

Objective

To determine the epidemiological features, course, and outcomes of critically ill pediatric patients with Influenza A (H1N1) virus.

Design

Prospective cohort of children in pediatric intensive care units (PICUs) due to Influenza A (H1N1) virus infection.

Setting

Seventeen medical-surgical PICUs in tertiary care hospital in Argentina.

Patients

All consecutive patients admitted to the PICUs with influenza A (H1N1) viral infection from 15 June to 31 July 2009.

Measurements and main results

Of 437 patients with acute lower respiratory infection in PICUs, 147 (34%) were diagnosed with influenza A (H1N1) related to critical illness. The median age of these patients was 10 months (IQR 3–59). Invasive mechanical ventilation was used in 117 (84%) on admission. The rate of acute respiratory distress syndrome (ARDS) was 80% (118 of 147 patients). Initial non-invasive ventilation failed in 19 of 22 attempts (86%). Mortality at 28 days was 39% (n = 57). Chronic complex conditions (CCCs), acute renal dysfunction (ARD) and ratio PaO2/FiO2 at day 3 on MV were independently associated with a higher risk of mortality. The odds ratio (OR) for CCCs was 3.06, (CI 95% 1.36–6.84); OR for ARD, 3.38, (CI 95% 1.45–10.33); OR for PaO2/FiO2, 4 (CI 95% 1.57–9.59). The administration of oseltamivir within 24 h after admission had a protective effect: OR 0.2 (CI 95% 0.07–0.54).

Conclusions

In children with ARDS, H1N1 as an etiologic agent confers high mortality, and the presence of CCCs in such patients increases the risk of death.
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Metadaten
Titel
Critically ill infants and children with influenza A (H1N1) in pediatric intensive care units in Argentina
verfasst von
Julio A. Farias
Analía Fernández
Ezequiel Monteverde
Nilda Vidal
Pilar Arias
María J. Montes
Gabriela Rodríguez
Mariela Allasia
Maria E. Ratto
Roxana Jaén
Claudia Meregalli
Karina Fiquepron
Ana R. Calvo
Alejandro Siaba
Lidia Albano
Rossana Poterala
Pablo Neira
Andrés Esteban
Publikationsdatum
01.06.2010
Verlag
Springer-Verlag
Erschienen in
Intensive Care Medicine / Ausgabe 6/2010
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-010-1853-1

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