hospitalized children with 2009 pandemic influenza a (h1n1) comparison to seasonal influenza and risk factors for admission to the icu住院患儿2009年甲型流感(h1n1)相比,季节性流感和进入icu的危险因素.pdfVIP

Hospitalized Children with 2009 Pandemic Influenza A (H1N1): Comparison to Seasonal Influenza and Risk Factors for Admission to the ICU 1 2 1 ´ 2 2 Dayanand Bagdure , Donna J. Curtis , Emily Dobyns , Mary P. Glode , Samuel R. Dominguez * 1 Department of Pediatric Critical Care, The Children’s Hospital, University of Colorado School of Medicine, Aurora, Colorado, United States of America, 2 Department of Pediatric Infectious Diseases, The Children’s Hospital, University of Colorado School of Medicine, Aurora, Colorado, United States of America Abstract Background: Limited data are available describing the clinical presentation and risk factors for admission to the intensive care unit for children with 2009 H1N1 infection. Methods: We conducted a retrospective chart review of all hospitalized children with 2009 influenza A (H1N1) and 2008–09 seasonal influenza at The Children’s Hospital, Denver, Colorado. Results: Of the 307 children identified with 2009 H1N1 infections, the median age was 6 years, 61% were male, and 66% had underlying medical conditions. Eighty children (26%) were admitted to the ICU. Thirty-two (40%) of the ICU patients required intubation and 17 (53%) of the intubated patients developed acute respiratory distress syndrome (ARDS). Four patients required extracorporeal membrane oxygenation. Eight (3%) of the hospitalized children died. Admission to the ICU was significantly associated with older age and underlying neurological condition. Compared to the 90 children admitted during the 2008–09 season, children admitted with 2009 H1N1 influenza were significantly older, had a shorter length of hospitalization, more use of antivirals, and a higher incidence of ARDS. Conclusions: Compared to the 2008–09 season,