Navigation Links
Children with chronic respiratory illness are vulnerable to critical H1N1
Date:3/11/2010

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 children behaved as though they had severe pneumonia. Some children had both or switched from one to the other. These variable and changing manifestations of lung infection made life support with a mechanical ventilator challenging and required us to constantly reassess and readjust treatments."

The researchers also found that children with H1N1 lung disease are at increased risk for developing a second type of pneumonia.

Patients who received treatment with antiviral drugs such as Tamiflu within 48 hours of admission did not have significantly different outcomes than those who received antiviral treatment more than 48 hours following admission.

Study offers positive assessment of PICU surge capacity during pandemic flu

Even during the peak of a pandemic, adequate health care can be provided if patients are managed appropriately. "An influenza pandemic for children can be managed, even allowing emergency care for non-influenza-related acute care children, but only when firm decision-making rules for hospital health care are followed and anti-viral therapy is used to reduce the burden of the disease in the community," said lead author Raoul E. Nap, PhD, directorate of medical affairs, quality, and safety at the University Medical Center Groningen, University of Groningen in the Netherlands.

The researchers modeled pediatric surge capacity of health care facility and pediatric intensive care unit (PICU) requirements over time to assess the adequacy of preparedness planning for an influenza pandemic.

They noted a lack of published and detailed analyses of PICU needs and demands, raising concern that PICU facilities will be a major limiting factor in the provision of care. "We show that PICU surge capacity is likely to be adequate assuming that 'older children' [age > 7-8 years] can be rerouted to an adult ICU environment preserving adequate bed space for 'younger children', that enough adult ICU resources are available and that safe provision of care to children can be guaranteed," said Dr. Nap.

The study's overall assessment that an influenza pandemic can be managed at the level of health care institutions clearly contrasts with other sobering and daunting global analyses presented for ICU capacity, according to Dr. Nap.

"We recommend that an adaptable planning model for pediatric surge capacity be an integral part of a preparedness plan for a pandemic flu," Dr. Nap concluded.

"H1N1 has greatly impacted every pediatric critical care medicine program world-wide," said PCCM editor Patrick M. Kochanek, MD, FCCM. "I view the dissemination of new information on this disease as the top priority for our journal. The reports from both Baltimore and the Netherlands in the March issue of Pediatric Critical Care Medicine present, respectively, valuable information on the impact of critical respiratory disease produced by H1N1 in children with underlying chronic conditions, and explores PICU surge capacity."


'/>"/>

Contact: Sophie Tosta
stosta@sccm.org
847-493-6406
Society of Critical Care Medicine
Source:Eurekalert

Related medicine news :

1. Children of depressed moms do better when dad is involved, SLU researcher finds
2. High pollution linked to poor lung function growth in children in Mexico City
3. NYC-area 1st: Morgan Stanley Childrens Hospital performs transcatheter pulmonary valve replacement
4. Obese Children Miss More School Days
5. Ultra-Runner to Run 63 Marathons in 63 Days for Children with Incurable Disease
6. Psoriasis Cure Now offers Back to School Resources for Parents of Children with Psoriasis
7. Researchers estimate about 9 percent of US children age 8 to 15 meet criteria for having ADHD
8. Majority of 2.4 Million U.S. Children With ADHD Not Diagnosed or Consistently Treated, According to New Gold Standard Study by Cincinnati Childrens Researchers
9. Practice-based intervention has sustained benefits for children and families
10. 1.5 million children could be saved
11. Annual flu shot cuts need for doctors visits, hospitalization among children
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/12/2016)... ... 12, 2016 , ... According to an article published February 4th ... significant portion of hernia repairs throughout the United States. Commenting on this article, Beverly ... that this trend has not only been expected, but it seems to be a ...
(Date:2/12/2016)... Raton, FL (PRWEB) , ... February 12, 2016 ... ... largest non-profit organization devoted exclusively to funding innovative lymphoma research and serving the ... services – hosted over 250 members of South Florida’s philanthropic community at its ...
(Date:2/12/2016)... ... February 12, 2016 , ... As a former television executive, ... demanding job, and no time to decompress, Rabinowitz found herself drawn to a casual ... for its impact on her life, implementing a 20-minute-per-day meditation practice with her team. ...
(Date:2/12/2016)... ... February 12, 2016 , ... Itopia, a leader ... integration of Clarity Intelligence Platform (CIP) into Cielo®, a discovery, migration and cloud ... (BI) to their small and medium business (SMB) clients. , In ...
(Date:2/12/2016)... ... February 12, 2016 , ... The Jones Agency, a family owned ... Texas, is launching a cooperative charity drive with the Tarrant Area Food Bank in ... 50,000 individuals and families in need, the Tarrant County Food Bank offers hope and ...
Breaking Medicine News(10 mins):
(Date:2/12/2016)... 12 februari 2016 AAIPharma Services ... leverancier van productie en ontwikkeling op maat ... vandaag een uitbreiding aan van steriele vul- ... in Charleston, SC . ... meerdere recente investeringen. http://photos.prnewswire.com/prnh/20150806/256637LOGO ...
(Date:2/11/2016)... - Cardiac Marker Diagnostic ... and Cancer Therapy. - European Point of Care ... - Key Diagnostic Testing Markets. - Molecular ... Genetic Testing. - Molecular Diagnostics in Infectious Disease ... Diagnostic Products World Markets. - Point of Care ...
(Date:2/11/2016)... -- Laboratory glassware and plasticware include equipment, ... range from microscope slides to large storage boxes and ... glass because of its low weight and resistance to ... gaining popularity over the past decade when it was ... plastic in several applications due to its resistance to ...
Breaking Medicine Technology: