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Cited by 60Influenza Virus Research StudiesRespiratory viral infections researchRespiratory Support and Mechanisms

Critical illness in children with influenza A/pH1N1 2009 infection in Canada*

Jouvet, Philippe, Hutchison, Jamie, Pinto, Ruxandra, Menon, Kusum, Rodin, Rachel, Choong, Karen, Kesselman, Murray, Veroukis, Stasa +11 more·2010·Pediatric Critical Care Medicine
DOI 10.1097/pcc.0b013e3181d9c80b
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Abstract

OBJECTIVE: To describe characteristics, treatment, and outcomes of critically ill children with influenza A/pandemic influenza A virus (pH1N1) infection in Canada. DESIGN: An observational study of critically ill children with influenza A/pH1N1 infection in pediatric intensive care units (PICUs). SETTING: Nine Canadian PICUs. PATIENTS: A total of 57 patients admitted to PICUs between April 16, 2009 and August 15, 2009. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Characteristics of critically ill children with influenza A/pH1N1 infection were recorded. Confirmed intensive care unit cases were compared with a national surveillance database containing all hospitalized pediatric patients with influenza A/pH1N1 infection. Risk factors were assessed with a Cox proportional hazard model. The PICU cohort and national surveillance data were compared, using chi-square tests. Fifty-seven children were admitted to the PICU for community-acquired influenza A/pH1N1 infection. One or more chronic comorbid illnesses were observed in 70.2% of patients, and 24.6% of patients were aboriginal. Mechanical ventilation was used in 68% of children, 20 children (35.1%) had acute lung injury on the first day of admission, and the median duration of ventilation was 6 days (range, 0-67 days). The PICU mortality rate was 7% (4 of 57 patients). When compared with nonintensive care unit hospitalized children, PICU children were more likely to have a chronic medical condition (relative risk, 1.73); aboriginal ethnicity was not a risk factor of intensive care unit admission. CONCLUSIONS: During the first outbreak of influenza A/pH1N1 infection, when the population was naïve to this novel virus, severe illness was common among children with underlying chronic conditions and aboriginal children. Influenza A/pH1N1-related critical illness in children was associated with severe hypoxemic respiratory failure and prolonged mechanical ventilation. However, this higher rate and severity of respiratory illness did not result in an increased mortality when compared with seasonal influenza.

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Authors
Jouvet, P., Hutchison, J., Pinto, R., Menon, K., Rodin, R., Choong, K., Kesselman, M., Veroukis, S., André Dugas, M., Santschi, M., Guerguerian, A.-M., Withington, D., Alsaati, B., Joffe, A. R., Drews, T., Skippen, P., Rolland, E., Kumar, A., & Fowler, R.
Affiliations
Université de Montréal (CA)
ORCID
Venue
Pediatric Critical Care Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2010-09
Volume
11
Issue
5
Pages
603-609
ISSN
1529-7535 (ISSN-L)
DOI
10.1097/pcc.0b013e3181d9c80b
OpenAlex
W2077478267
Cited by
60
References
22
Citations by year
2024: 1 · 2023: 1 · 2020: 1 · 2018: 3 · 2016: 3 · 2015: 2 · 2014: 7 · 2013: 6 · 2012: 14
FWCI
9.77
Type
journal article
Language
en
Open access
closed
Locations
  • Pediatric Critical Care Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
University of Toronto
Topics
  • Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
  • Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
Keywords
influenza A (H1N1) 2009 pandemic, critically ill children, children, mechanical ventilation, acute lung injury, hypoxemic respiratory failure, chronic comorbidities, Aboriginal children, mortality, risk factors, pediatric intensive care
MeSH terms
Adolescent, Canada, Child, Child, Preschool, Female, Humans, Infant, Influenza, Human, Length of Stay, Male, Respiration, Artificial, Risk Factors, Socioeconomic Factors, Intensive Care Units, Pediatric, Critical Illness, Hospital Mortality, Influenza A Virus, H1N1 Subtype, Pandemics

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