Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Children with chronic respiratory illness are vulnerable to critical H1N1

12.03.2010
Pediatric ICU capacity can be managed to meet the demands of a flu pandemic

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."

Published by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, Pediatric Critical Care Medicine is the first peer-reviewed scientific journal to focus exclusively on pediatric and neonatal critical care medicine. The bimonthly journal's regular content includes clinical papers, scientific investigations, and solicited reviews. Selected abstracts from articles in each issue are published in Chinese, French, Italian, Japanese, Portuguese, and Spanish. Additionally, selected abstracts from relevant scientific meetings appear in the journal.

Sophie Tosta | EurekAlert!
Further information:
http://www.sccm.org

Further reports about: H1N1 H1N1 influenza ICU Medicine PCCM PICU Pediatric chronic condition influenza pandemic pandemic flu

More articles from Health and Medicine:

nachricht Team discovers how bacteria exploit a chink in the body's armor
20.01.2017 | University of Illinois at Urbana-Champaign

nachricht Rabies viruses reveal wiring in transparent brains
19.01.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Traffic jam in empty space

New success for Konstanz physicists in studying the quantum vacuum

An important step towards a completely new experimental access to quantum physics has been made at University of Konstanz. The team of scientists headed by...

Im Focus: How gut bacteria can make us ill

HZI researchers decipher infection mechanisms of Yersinia and immune responses of the host

Yersiniae cause severe intestinal infections. Studies using Yersinia pseudotuberculosis as a model organism aim to elucidate the infection mechanisms of these...

Im Focus: Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.

While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...

Im Focus: Studying fundamental particles in materials

Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales

Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...

Im Focus: Designing Architecture with Solar Building Envelopes

Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Sustainable Water use in Agriculture in Eastern Europe and Central Asia

19.01.2017 | Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

 
Latest News

An innovative high-performance material: biofibers made from green lacewing silk

20.01.2017 | Materials Sciences

Ion treatments for cardiac arrhythmia — Non-invasive alternative to catheter-based surgery

20.01.2017 | Life Sciences

Bodyguards in the gut have a chemical weapon

20.01.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>