2009年豚由来A型新型インフルエンザ（A/H1N1 pdm）による小児重症症例集積報告

志馬 伸朗; 清水 直樹; 植田 育也; 中矢代 真美; 渡部 誠一; 平井 克樹; 阿部 世紀; 中川 聡

doi:10.3918/jsicm.17.87

INVESTIGATION REPORT

Pediatric cases of 2009 pandemic swine-oriented influenza (A/H1N1 pdm) requiring mechanical ventilation in the Japanese pediatric intensive care unit

Nobuaki Shime, Naoki Shimizu, Ikuya Ueta, Mami Nakayashiro, Seiichi Watanabe, Katsuki Hirai, Seiki Abe, Satoshi Nakagawa

Author information

Nobuaki Shime
The Japanese Society of Intensive Care Medicine-Pediatric Intensive Care Unit (JSICM-PICU) network, Neonatal and Pediatric Intensive Care Committee, Japanese Society of Intensive Care Medicine
Intensive Care Division, Department of Anesthesiology and Intensive Care, Kyoto Prefectural University of Medicine
Naoki Shimizu
The Japanese Society of Intensive Care Medicine-Pediatric Intensive Care Unit (JSICM-PICU) network, Neonatal and Pediatric Intensive Care Committee, Japanese Society of Intensive Care Medicine
Department of Emergency & Intensive Care Medicine, Kimitsu Chuo Hospital
Ikuya Ueta
The Japanese Society of Intensive Care Medicine-Pediatric Intensive Care Unit (JSICM-PICU) network, Neonatal and Pediatric Intensive Care Committee, Japanese Society of Intensive Care Medicine
Pediatric Intensive Care Center, Shizuoka Prefectural Children's Hospital
Mami Nakayashiro
The Japanese Society of Intensive Care Medicine-Pediatric Intensive Care Unit (JSICM-PICU) network, Neonatal and Pediatric Intensive Care Committee, Japanese Society of Intensive Care Medicine
Department of Pediatric Cardiology, Okinawa Nanbu Medical Center & Children's Center
Seiichi Watanabe
The Japanese Society of Intensive Care Medicine-Pediatric Intensive Care Unit (JSICM-PICU) network, Neonatal and Pediatric Intensive Care Committee, Japanese Society of Intensive Care Medicine
Department of Pediatrics, Tsuchiura Kyodo Hospital
Katsuki Hirai
The Japanese Society of Intensive Care Medicine-Pediatric Intensive Care Unit (JSICM-PICU) network, Neonatal and Pediatric Intensive Care Committee, Japanese Society of Intensive Care Medicine
Department of Pediatrics, Kumamoto Red-cross Hospital
Seiki Abe
The Japanese Society of Intensive Care Medicine-Pediatric Intensive Care Unit (JSICM-PICU) network, Neonatal and Pediatric Intensive Care Committee, Japanese Society of Intensive Care Medicine
Department of Intensive Care Medicine, Nagano Children's Hospital
Satoshi Nakagawa
The Japanese Society of Intensive Care Medicine-Pediatric Intensive Care Unit (JSICM-PICU) network, Neonatal and Pediatric Intensive Care Committee, Japanese Society of Intensive Care Medicine
Department of Anesthesia & Intensive Care Medicine, National Center of Child Health and Development

Keywords: A/H1N1 pdm, pediatric, mechanical ventilation

JOURNAL FREE ACCESS

2010 Volume 17 Issue 1 Pages 87-95

DOI https://doi.org/10.3918/jsicm.17.87

Details

Abstract

Objectives: In response to an outbreak of H1N1 influenza (A/H1N1 pdm) in Japan in 2009, The Japanese Society of Intensive Care Medicine-Pediatric Intensive Care Unit (JSICM-PICU) network, a task-force of the Neonatal and Pediatric Intensive Care Committee in The Japanese Society of Intensive Care Medicine evaluated a group of critically ill children with A/H1N1 pdm. Methods: The characteristics, treatment and outcomes of A/H1N1 pdm cases of children under 15 years old identified in August to October 2009 were surveyed by the network. Results: Nine patients, with a median age of 5 years and 3 months, received mechanical ventilation in ICU due to confirmed infection of A/H1N1 pdm. Although the average predicted mortality by the Pediatric Index of Mortality-2 (PIM-2) was 15.4%, none of these children died. Indications for initiation of mechanical ventilation were acute respiratory failure due to asthma, bronchitis or pneumonia in 5 cases, decreased level of consciousness due to enchepharopathy in 3 cases and circulatory failure due to myocarditis in 1 case. Two patients required extracorporeal membrane oxygenation for severe cardio-respiratory failure. All patients received oseltamivir, an antiviral agent for treatment of the A/H1N1 pdm, with the median time from onset of symptoms of influenza to initiation of oseltamivir 1 day. Conclusions: Information regarding a larger number of cases is necessary to develop optimal diagnostic and therapeutic strategies for severe A/H1N1 pdm infection in children.

Corresponding author

Correction information

Register with J-STAGE for free!