Mt. Prospect, Ill. As critical care professionals develop a better understanding of the progression of H1N1, they are becoming better prepared to treat children with severe cases, according to a new study that will be published in the March issue of Pediatric Critical Care Medicine (PCCM).
Additionally, with careful management, the pediatric critical care system is expected to be able to meet the increased demands of a flu pandemic, according to a resource modeling study published in the same issue of PCCM. Both studies are available on www.pccmjournal.org.
The first H1N1 study focusing exclusively on critically ill children found that children with chronic illness, especially respiratory illness, are more likely to develop H1N1 influenza that requires critical care and that the virus is likely to change course as it attacks the lungs throughout the course of the illness.
"The good news is that all of our patients survived, even though some needed mechanical ventilators and heart medication," said senior author David G. Nichols, MD, professor of anesthesiology/critical care medicine and pediatrics at the Johns Hopkins University School of Medicine.
Compared to seasonal influenza, H1N1 influenza appears to have increased infection rates among children and young adults and varies in severity.
The researchers reviewed cases of 13 critically ill children with H1N1 admitted to the Johns Hopkins Hospital Children's Center pediatric intensive care unit during the spring and summer of 2009. They found that the vast majority (92%) of the children had an underlying chronic disease, usually a lung disease such as asthma, before contracting H1N1 infection.
"Critical H1N1 disease in children has different and rapidly changing manifestations in the patients' lungs," explained Dr. Nichols. "Some children behaved as though they were having an asthma attack, while other c
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Society of Critical Care Medicine