Intensive Care Unit, Women's and Children's Hospital, Adelaide, Australia.
Pediatrics. 2011 Jan;127(1):e156-63. doi: 10.1542/peds.2010-0801. Epub 2010 Dec 20.
To describe in detail the pediatric intensive care experience of influenza A, particularly pandemic H1N1-09, in Australia and New Zealand during the 2009 Southern Hemisphere winter and to compare the pediatric experience with that of adults.
This was an inception-cohort study of all children who were admitted to intensive care with confirmed influenza A during winter 2009 at all general ICUs and PICUs in Australia and New Zealand.
From June 1 through August 31, 2009, 107 children (20.0 per million [95% confidence interval: 16.1-23.8]) with influenza A, including 83 (15.5 per million [95% confidence interval: 12.1-18.9]) with H1N1-09 were admitted to ICUs. Fifty-two percent (39 of 75) of children with H1N1-09 had 1 or more comorbidity, most commonly neurologic (20%). Most (48 of 83 [58%]) presented with pneumonia. Thirteen of 83 (16%) had neurologic presentations. Eighty percent of the children with H1N1-09 required ventilation. Mortality was lower than in adults: 6 of 83 (7%) vs 114 of 668 (17%) (P = .02). The median length of stay for children with H1N1-09 was 5 days. Children with H1N1-09 occupied 773 bed-days (147 per million children) and 5.8% of specialist PICU beds. Presentation with septic shock or after cardiac arrest and the presence of 1 or more comorbidities were risk factors for severe disease.
H1N1-09 caused a substantial burden on pediatric intensive care services in Australia and New Zealand. Compared with adults, children more commonly had nonrespiratory presentations and required ventilation more often but had a lower mortality rate.
详细描述澳大利亚和新西兰 2009 年南半球冬季甲型流感（尤其是 H1N1-09 大流行株）在儿科重症监护病房的发病情况，并将儿科患者的发病情况与成人进行比较。
这是一项在澳大利亚和新西兰所有普通 ICU 和儿科 ICU 进行的甲型流感确诊患儿的病例系列研究。
2009 年 6 月 1 日至 8 月 31 日，共有 107 例甲型流感患儿（每百万 20.0 例[95%置信区间：16.1-23.8]），包括 83 例 H1N1-09 患儿（每百万 15.5 例[95%置信区间：12.1-18.9]）收入 ICU。83 例 H1N1-09 患儿中，52%（39 例）存在 1 种或多种合并症，最常见的是神经系统疾病（20%）。大多数（48/83[58%]）患儿表现为肺炎，13 例（16%）有神经系统表现。83 例患儿中，80%需要通气治疗。H1N1-09 患儿死亡率低于成人：6/83（7%）比 668/83（17%）（P=0.02）。H1N1-09 患儿的中位住院时间为 5 天。H1N1-09 患儿占用 773 张床位（每百万儿童 147 张）和 5.8%的专科儿科 ICU 床位。出现感染性休克或心脏骤停后入院以及存在 1 种或多种合并症是病情严重的危险因素。
H1N1-09 在澳大利亚和新西兰儿科重症监护病房造成了很大的负担。与成人相比，儿童更常出现非呼吸系统表现，更常需要通气治疗，但死亡率较低。
