Rapidly Progressive Complications of the Influenza A Type in Children
Authors:
J. Kobr 1; K. Pizingerová 1; L. Šašek 1; J. Fremuth 1; P. Honomichl 1; R. Vondráková 2; J. Kudová 3; T. Bergerová 3; J. Racek 4
Authors‘ workplace:
Dětská klinika, Univerzita Karlova v Praze, Lékařská fakulta v Plzni a Fakultní nemocnice Plzeň
přednosta doc. MUDr. J. Kobr, PhD.
1; Klinika zobrazovacích metod, Univerzita Karlova v Praze, Lékařská fakulta v Plzni a Fakultní nemocnice Plzeň
přednosta doc. MUDr. B. Kreuzberg, CSc.
2; Ústav mikrobiologie, Univerzita Karlova v Praze, Lékařská fakulta v Plzni a Fakultní nemocnice Plzeň
vedoucí RNDr. K. Fajfrlík, PhD.
3; Ústav klinické biochemie a hematologie, Univerzita Karlova v Praze, Lékařská fakulta v Plzni a Fakultní nemocnice Plzeň
vedoucí prof. MUDr. J. Racek, DrSc.
4
Published in:
Čes-slov Pediat 2010; 65 (6): 386-393.
Category:
Original Papers
Overview
Introduction:
The aim of the study was the effects of active prevention and reducing the overall length of hospital stay increases the effectiveness of treatment of pulmonary complications of influenza type A in children.
Design:
Clinical, prospective study in Department of Paediatrics-PICU, University Hospital in Pilsen.
Material and methods:
Including criteria were acute lung injury (ALI) and ongoing infection of influenza type A. Children without evidence of this infection were excluded. Between October and December 2009 a total of 9 children were enrolled, average age of 6.2 years (range 0.3–15 years). Anti-infective treatment was conducted combining antivirals and antibiotics.
Results:
Influenza A virus isolation and RNA virus in tracheal aspirate showed ongoing infection in 9 children, in 6 children (67%) with Pandemic A (H1N1) 2009 subtype. Bacterial co-infection was detected in 8 children (89%). Acute lung injury corresponded to the average Lung Injury Score File (LIS; 1.9±0.76 points). Index Predicted Risk of Mortality Score (PRISM; 14.7±8.67 points) predicted 12% mortality for the group. Chronic risk existed in 6 children, but they were not vaccinated. Mechanical ventilation of 5 children lasted an average of 11.2±3.29 and non-invasive ventilation of 3 children an average of 1.9±0.85 days. Four children had unilateral chest empyema and 3 children had pneumothorax. Thoracic drainage lasted an average of 7.8±5.56 days. Data analysis confirmed the correlation between the absence of vaccination (r=0.989; p<0.001), bacterial co-infection (r=0.543; p<0.01) and chronic risk (r=0.425; p<0.05) on the one hand and the severity of lung impairment on the other hand. All nine children from the study were clinically healed with minimal residual pulmonary findings. The average length of hospitalization of our patients was 17.33±3.27 days.
Conclusions:
The absence of vaccination, bacterial co-infection and chronic risk were the factors development of severe pulmonary complications during the influenza in children. Early launch of a comprehensive treatment was effective in preventing permanent disability.
Key words:
influenza A type, acute lung injury, bacterial co-infection, thoracic empyema, chronic risk, vaccination
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Labels
Neonatology Paediatrics General practitioner for children and adolescentsArticle was published in
Czech-Slovak Pediatrics
2010 Issue 6
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