[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.