• Silvio Fabio Torres, Thomas Iolster, Eduardo Julio Schnitzler, Julio Alberto Farias, Adriana Claudia Bordogna, Daniel Rufach, María José Montes, Alejandro Javier Siaba, María Gabriela Rodríguez, Roberto Jabornisky, Carmen Colman, Analia Fernández, Gustavo Caprotta, Silvia Diaz, Roxana Poterala, Marcela De Meyer, Matías Enrique Penazzi, Gustavo González, Silvia Saenz, Oscar Recupero, Luis Zapico, Blanca Alarcon, Esen Ariel, Pablo Minces, Eduardo Mari, Antonio Carnie, Mónica Garea, and Roxana Jaen.
• Hospital Universitario Austral, Argentina. storres@cas.austral.edu.ar
• Pediatr Crit Care Me. 2012 Mar 1;13(2):e78-83.

ObjectiveTo describe the clinical characteristics and outcome of patients admitted to pediatric intensive care with influenza A (pH1N1) 2009 in Argentina.DesignRetrospective observational study.SettingThirteen pediatric intensive care units in Argentina.SubjectsOne hundred and forty-two patients with confirmed or suspected influenza A (H1N1).InterventionsNone.Measurements And Main ResultsWe included 142 critically ill patients. The median age was 19 months (range, 2-110 months) with 39% of the patients <24 months of age. Ninety-nine patients (70%) had an underlying disease. Influenza A (pH1N1) 2009 infection was confirmed in 90 patients and the remaining 52 had a positive direct immunofluorescence assay for influenza A. The median length of stay in the pediatric intensive care unit was 12 days (range, 2-52 days). One hundred eighteen patients (83%) received invasive mechanical ventilation and 19 patients were treated with noninvasive ventilation; however, seven of the patients receiving noninvasive ventilation later needed mechanical ventilation. Sixty-eight patients died (47%) with the most frequent cause refractory hypoxemia. Multivariate logistic regression analysis showed that age <24 months (odds ratio, 2.87; 2.35-3.93), asthma (odds ratio, 1.34; 1.20-2.91), and respiratory coinfection with respiratory syncytial virus (odds ratio, 2.92; 1.20-4.10) were associated with higher mortality. As expected, mechanical ventilation and treatment with inotropes were also associated with increased mortality.ConclusionsThe mortality of children admitted to the pediatric intensive care unit with 2009 pH1N1 influenza was high (47%) in our population. Age <24 months, asthma, respiratory coinfection, need of mechanical ventilation, and treatment with inotropes were predictors of poorer outcome.

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