[Influenza in pediatric intensive cure unit].

OBJECTIVES: The purpose was to identify clinical presentation leading to admission to PICU of children affected by influenza, to describe predisposing factors and outcome and to propose preventive measures.

METHODS: Ten years (1989-1999) retrospective study carried out in the ten beds PICU. Every child in PICU with an influenza positive culture was enrolled.

RESULTS: Twenty four cases collected, aged two weeks-15 years (m =43 months), 19 males. Acute respiratory failure (16/24 =67%) was the first manifestation: pneumonia (13), bronchiolitis (2), status asthmaticus (1). Eleven children had underlying diseases including five immunocompromized. Thirteen patients required mechanical ventilation (mean duration: 22 days), seven developed ARDS (4 immunocompromized) and three died. Central nervous system was the second system affected (8 cases). Four exhibited a chronical cerebral disease and five presented afebrile status epilepticus which required i.v. barbiturates and mechanical ventilation (mean duration: 22 hours). One presented encephalitis, one an apparent life-threatening event, both had a favorable outcome. One child exhibited severe hyperpyrexia and died from multiorgan failure.

CONCLUSION: Severe forms of influenza are rare in children but may lead to life-threatening conditions and death(16.5%). Most occur in children with underlying disease, particularly immunocompromized who may exhibit ARDS.