Critically ill infants and children with influenza A (H1N1) in pediatric intensive care units in Argentina
| Autor: | Julio A. Farias, A. Fernandez, Karina Fiquepron, María José Montes, Rossana Poterala, Lidia Albano, Mariela Allasia, Pablo Neira, Andrés Esteban, Nilda Vidal, Claudia Meregalli, Ezequiel Monteverde, María Elena Ratto, Roxana Jaen, Ana R. Calvo, Alejandro Siaba, Gabriela Rodríguez, Pilar Arias |
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| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
Male
Oseltamivir Pediatrics medicine.medical_specialty ARDS Influenza A (H1N1) medicine.medical_treatment Critical Illness Argentina Infants and children Critical Care and Intensive Care Medicine medicine.disease_cause Cohort Studies chemistry.chemical_compound Mechanical ventilation Influenza A Virus H1N1 Subtype Intensive care Intensive Care Units Neonatal Influenza Human medicine Influenza A virus Risk of mortality Humans Prospective Studies Critically ill Survey business.industry Infant Newborn Infant Odds ratio medicine.disease Survival Analysis Treatment Outcome chemistry Pediatric Original Female business Cohort study |
| Zdroj: | Intensive Care Medicine |
| ISSN: | 1432-1238 0342-4642 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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