Department of Pediatric Critical Care, The Children's Hospital, University of Colorado School of Medicine, Aurora, Colorado, United States of America.
PLoS One. 2010 Dec 15;5(12):e15173. doi: 10.1371/journal.pone.0015173.
Limited data are available describing the clinical presentation and risk factors for admission to the intensive care unit for children with 2009 H1N1 infection.
We conducted a retrospective chart review of all hospitalized children with 2009 influenza A (H1N1) and 2008-09 seasonal influenza at The Children's Hospital, Denver, Colorado.
Of the 307 children identified with 2009 H1N1 infections, the median age was 6 years, 61% were male, and 66% had underlying medical conditions. Eighty children (26%) were admitted to the ICU. Thirty-two (40%) of the ICU patients required intubation and 17 (53%) of the intubated patients developed acute respiratory distress syndrome (ARDS). Four patients required extracorporeal membrane oxygenation. Eight (3%) of the hospitalized children died. Admission to the ICU was significantly associated with older age and underlying neurological condition. Compared to the 90 children admitted during the 2008-09 season, children admitted with 2009 H1N1 influenza were significantly older, had a shorter length of hospitalization, more use of antivirals, and a higher incidence of ARDS.
Compared to the 2008-09 season, hospitalized children with 2009 H1N1 influenza were much older and had more severe respiratory disease. Among children hospitalized with 2009 H1N1 influenza, risk factors for admission to the ICU included older age and having an underlying neurological condition. Children under the age of 2 hospitalized with 2009 H1N1 influenza were significantly less likely to require ICU care compared to older hospitalized children.
关于患有 2009 年 H1N1 感染的儿童入住重症监护病房的临床表现和危险因素，目前仅有有限的数据可供描述。
我们对科罗拉多州丹佛市儿童医院所有因 2009 年甲型流感（H1N1）和 2008-09 年季节性流感住院的儿童进行了回顾性病历审查。
在确定的 307 例患有 2009 年 H1N1 感染的儿童中，中位年龄为 6 岁，61%为男性，66%有基础疾病。80 例（26%）患儿入住重症监护病房。32 例（40%）重症监护病房患儿需要插管，17 例（53%）插管患儿发生急性呼吸窘迫综合征（ARDS）。4 例患儿需要体外膜氧合。8 例（3%）住院患儿死亡。入住重症监护病房与年龄较大和基础神经系统疾病显著相关。与 2008-09 年季节住院的 90 例患儿相比，患有 2009 年 H1N1 流感的患儿年龄明显较大，住院时间较短，抗病毒药物使用率更高，ARDS 发生率更高。
与 2008-09 年季节相比，因 2009 年 H1N1 流感住院的儿童年龄较大，且呼吸系统疾病更严重。在因 2009 年 H1N1 流感住院的儿童中，入住重症监护病房的危险因素包括年龄较大和有基础神经系统疾病。与年龄较大的住院患儿相比，因 2009 年 H1N1 流感住院的 2 岁以下儿童明显较少需要重症监护病房护理。
