title: Analysis of cases of severe respiratory failure in children with influenza (H1N1) 2009 infection in Japan.
abstract: Influenza (H1N1) 2009 occurred in Mexico in April 2009, quickly spread around the world, and was found in Japan in May. Many pediatric patients experienced encephalopathy, acute respiratory distress syndrome, and severe pneumonia. The subjects of this study were 31 pediatric patients who needed mechanical ventilation due to respiratory failure caused by influenza (H1N1) 2009 as reported to the Emergency Medical Information Center of the Japan Pediatric Society in Kanagawa Prefecture in Japan from August 1 to December 31, 2009. The diagnosis of influenza (H1N1) 2009 infection was based on positive results of a real-time polymerase chain reaction. No patient was diagnosed as having a bacterial infection. The average arterial PaO(2)/FiO(2) ratio was significantly decreased to 126. Atelectasis was revealed by chest X-ray in 90.3% of subjects. There was one plastic bronchitis patient. Anti-influenza drugs were used at an average of 14.9 h after onset. Five patients showed abnormal behavior as a complication of encephalopathy. We found that respiratory failure progressed rapidly. The type of respiratory failure was oxygenation failure. It was helpful to attempt to remove more sputum in these cases. Pediatric patients with respiratory failure from influenza (H1N1) 2009 should be carefully monitored for the onset of encephalopathy.
authors.affiliation: Department of Pediatrics, Yokohama Minami Kyosai Hospital, 1-21-1 mutsuura-higashi, Kanazawa-ku, Yokohama, Kanagawa, 236-0037, Japan. u.106-1028@hotmail.co.jp
authors.forename: Toru
authors.initials: T
authors.lastname: Uchimura
authors.forename: Masaaki
authors.initials: M
authors.lastname: Mori
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Nariai
authors.forename: Shumpei
authors.initials: S
authors.lastname: Yokota
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D001927:Brain Diseases / Q000209:etiology / Q000821:virology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000821:virology; D007564:Japan / Q000453:epidemiology; D008297:Male; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000453:epidemiology / Q000821:virology*; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents