| Autor: |
Farias, Julio A., Fernández, Analía, Monteverde, Ezequiel, Vidal, Nilda, Arias, Pilar, Montes, María J., Rodríguez, Gabriela, Allasia, Mariela, Ratto, Maria E., Jaén, Roxana, Meregalli, Claudia, Fiquepron, Karina, Calvo, Ana R., Siaba, Alejandro, Albano, Lidia, Poterala, Rossana, Neira, Pablo, Esteban, Andrés |
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| Zdroj: |
Intensive Care Medicine; Jun2010, Vol. 36 Issue 6, p1015-1022, 8p, 1 Diagram, 3 Charts |
| Abstrakt: |
To determine the epidemiological features, course, and outcomes of critically ill pediatric patients with Influenza A (H1N1) virus. Prospective cohort of children in pediatric intensive care units (PICUs) due to Influenza A (H1N1) virus infection. Seventeen medical-surgical PICUs in tertiary care hospital in Argentina. All consecutive patients admitted to the PICUs with influenza A (H1N1) viral infection from 15 June to 31 July 2009. 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). 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. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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