Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Pediatr Crit Care Med. 2012 May;13(3):e140-4. doi: 10.1097/PCC.0b013e318228845f.
To compare the clinical features, management, and outcome of critically ill children with H1N1 to children with seasonal influenza from the previous three influenza seasons.
The overall number of hospitalizations and the proportion cared for in the pediatric intensive care unit during the H1N1 epidemic period and the three previous influenza seasons (2007-2009) were determined. Medical records of patients admitted to the pediatric intensive care unit with H1N1 and seasonal influenza infection were reviewed.
Cincinnati Children's Hospital Medical Center, a large, 523-bed hospital located in Cincinnati.
Hospitalized children with laboratory-confirmed seasonal or H1N1 infection.
Study variables included demographic data (age, gender), clinical factors (weight, Pediatric Risk of Mortality III scores, presenting signs and symptoms, comorbid conditions), management (length of mechanical ventilation, other treatments, including high-frequency oscillatory ventilatory support, inhaled nitric oxide, or extracorporeal membrane oxygenation), and outcome (overall and pediatric intensive care unit length of stay and mortality).
Overall, 312 children were hospitalized with H1N1 and 222 with seasonal influenza from the three previous seasons. Children with H1N1 infection were significantly less likely to require pediatric intensive care unit care compared to children with seasonal influenza infection (14% vs. 24%, p = .02). Compared to children with seasonal influenza, children in the pediatric intensive care unit with H1N1 were older (median age in months 107 vs. 68, p = .05) and significantly more likely to have comorbid conditions (64% vs. 40%, p = .03), especially respiratory conditions. While there were no significant differences in severity of illness by Pediatric Risk of Mortality III scores or pediatric intensive care unit length of stay, children with H1N1 were significantly less likely to have acute respiratory failure (p = .04) or die compared to children with seasonal influenza infection (p = .03).
In contrast to other studies, we found that critically ill children with H1N1 had a significantly lower morbidity and mortality compared to children with seasonal influenza.
比较 H1N1 流感危重症患儿与前三个流感季节季节性流感患儿的临床特征、治疗方法和结局。
确定 H1N1 流行期间和前三个流感季节（2007-2009 年）住院总人数和在儿科重症监护病房（PICU）接受治疗的比例。回顾因感染季节性或 H1N1 流感入住儿科重症监护病房的患者的病历。
辛辛那提儿童医院医疗中心，这是一家位于辛辛那提市的大型 523 床位医院。
实验室确诊的季节性或 H1N1 感染住院患儿。
研究变量包括人口统计学数据（年龄、性别）、临床因素（体重、儿科危重病评分 3 分、表现出的体征和症状、合并症）、治疗方法（机械通气时间、高频振荡通气支持、吸入性一氧化氮或体外膜肺氧合等其他治疗）和结局（总住院时间、PICU 住院时间和死亡率）。
总体而言，312 例 H1N1 患儿和 222 例前三个流感季节季节性流感患儿住院。与季节性流感感染患儿相比，H1N1 感染患儿接受 PICU 治疗的可能性显著降低（14%比 24%，p =.02）。与季节性流感患儿相比，PICU 内 H1N1 患儿年龄更大（中位数年龄月数为 107 比 68，p =.05），合并症的可能性显著更高（64%比 40%，p =.03），尤其是呼吸系统疾病。虽然儿科危重病评分 3 分或 PICU 住院时间无显著差异，但与季节性流感感染患儿相比，H1N1 患儿发生急性呼吸衰竭的可能性较小（p =.04），死亡率也较低（p =.03）。
与其他研究不同，我们发现与季节性流感患儿相比，H1N1 流感危重症患儿的发病率和死亡率显著较低。
