Critically ill children with pandemic influenza (H1N1) in pediatric intensive care units in Turkey

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dc.contributor.authorKendirli, Tanil
dc.contributor.authorDemirkol, Demet
dc.contributor.authorYildizdas, Dincer
dc.contributor.authorAnil, Ayse Berna
dc.contributor.authorAsilioglu, Nazik
dc.contributor.authorKarapinar, Bulent
dc.contributor.authorErkek, Nilgun
dc.contributor.authorSevketoglu, Esra
dc.contributor.authorDursun, Oguz
dc.contributor.authorArslankoylu, Ali Ertug
dc.contributor.authorBayrakci, Benan
dc.contributor.authorBosnak, Mehmet
dc.contributor.authorKoroglu, Tolga
dc.contributor.authorHoroz, Ozgur Ozden
dc.contributor.authorCitak, Agop
dc.contributor.authorKesici, Selman
dc.contributor.authorAtes, Can
dc.contributor.authorKarabocuoglu, Metin
dc.contributor.authorInce, Erdal
dc.date.accessioned2019-10-27T21:34:42Z
dc.date.available2019-10-27T21:34:42Z
dc.date.issued2012
dc.departmentEge Üniversitesien_US
dc.description.abstractObjectives: To outline the epidemiologic features, clinical presentation, clinical courses, and outcomes in critically ill children with pandemic influenza in pediatric intensive care units. Design: Retrospective, observational, multicenter study. Setting: Thirteen tertiary pediatric intensive care units in Turkey. Patients: Eighty-three children with confirmed infection attributable to pandemic influenza detected by reverse-transcriptase polymerase chain reaction assay between November 1 and December 31, 2009 who were admitted to critical care units. Interventions: None. Measurements and Main Results: During a 2-month period, 532 children were hospitalized with pandemic influenza and 83 (15.6%) needed critical care. For the 83 patients requiring critical care, the median age was 42 (range, 2-204) months, with 24 (28.9%) and 48 (57.8%) of patients younger than 2 and 5 yrs, respectively. Twenty (24.1%) patients had no underlying illness, but 63 (75.9%) children had an underlying chronic illness. Indications for admission to the pediatric intensive care unit were respiratory failure in 66 (79.5%), neurologic deterioration in six (7.2%), and gastrointestinal symptoms in five (6.0%) patients. Acute lung injury was diagnosed in 23 (27.7%), acute respiratory distress syndrome was diagnosed in 34 (41%), and 51 (61.4%) patients were mechanically ventilated. Oseltamivir was used in 80 (96%) patients. The mortality rate for children with pandemic influenza 2009 was 30.1% compared to an overall mortality rate of 13.7% (p = .0016) among pediatric intensive care unit patients without pandemic influenza during the study period. Also, the mortality rate was 31.7% in patients with comorbidities and 25.0% in previously healthy children (p = .567). The cause of death was primary pandemic influenza infection in 16 (64%), nosocomial infection in four (16%), and primary disease progression in five (20%) patients. The odds ratio for respiratory failure was 14.7 (95% confidence interval, 1.85-111.11), and odds ratio for mechanical ventilation was 27.7 (95% confidence interval, 0.003-200). Conclusions: Severe disease and high mortality rates were seen in children with pandemic influenza. Death attributable to pandemic influenza occurred in all age groups of children with or without underlying illness. Multiple organ dysfunction syndrome is associated with increased mortality, and death is frequently secondary to severe lung infection caused by pandemic influenza. (Pediatr Crit Care Med 2012; 13:e11-e17)en_US
dc.identifier.doi10.1097/PCC.0b013e31820aba37en_US
dc.identifier.endpageE17en_US
dc.identifier.issn1529-7535
dc.identifier.issn1947-3893
dc.identifier.issue1en_US
dc.identifier.pmid21263368en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpageE11en_US
dc.identifier.urihttps://doi.org/10.1097/PCC.0b013e31820aba37
dc.identifier.urihttps://hdl.handle.net/11454/45664
dc.identifier.volume13en_US
dc.identifier.wosWOS:000299073000003en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherLippincott Williams & Wilkinsen_US
dc.relation.ispartofPediatric Critical Care Medicineen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectpandemic influenzaen_US
dc.subjectH1N1en_US
dc.subjectchildrenen_US
dc.subjectpediatric intensive careen_US
dc.subjectmortalityen_US
dc.subjectmorbidityen_US
dc.titleCritically ill children with pandemic influenza (H1N1) in pediatric intensive care units in Turkeyen_US
dc.typeArticleen_US

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