Objective To analyze the clinical features and treatment of severe H1N1 influenza.Methods The clinical data of 34 patients with severe H1N1 influenza admitted to intensive care unit from October to December 2009 were reviewed. Results The patients aged 3 months to 60 years with an average of ( 13. 9 ±4. 5) years, of which 24 patients were younger than 7 years old. Fever( 30 cases) , cough( 32 cases) , progressive shortness of breath( 19 cases) were the main symptoms. White blood cell count was normal in 21 cases, increased in 6 cases, and decreased in 7 cases. Lymphocyte count was normal in 16 cases, increased in 12 cases, and decreased in6 cases. Chest X-ray films showed bilateral or unilateral patchy pulmonary fuzzy shadows in28 cases. Chest CT showed diffuse interstitial lesion in1 case, pleural effusion in 2 cases, and bronchiectasis in 1 case. The hepatic and myocardial enzymogramparameters were all abnormal.30 cases were treated by oseltamivir and ribavirin, 4 cases by methyllprednisolone, and 6 cases by gamma globulin. 8 cases underwent routine intubation and mechanical ventilation, and 5 cases received non-invasive mechanical ventilation. All 34 patients were cured. Conclusions Lung, heart, and liver are the major target organs in severe H1N1 influenza. Mechanical ventilatory support is an important treatment for severe H1N1influenza.
Objective To investigate the clinical characteristics and treatment of severe H1N1 influenza during pregnancy and postpartum.Methods Clinical data of 7 pregnant women and 2 postpartum women with severe H1N1 influenza admitted from October to December 2009 were reviewed. Results Three pregnant women underwent caesarean section during hospitalization. The main symptoms included fever ( in9 cases, and fever lasted more than 3 days in 7 cases) , cough and sputum ( in 9 cases) , and dyspnea ( in 7 cases) . Asthenia and muscular soreness were not serious, and there were no accompanying symptoms of digestive tract. Moist rales were heard in 5 cases. White blood cell count decreased in 3 cases, neutrophils increased in 6 cases, and lymphocytes reduced in 7 cases. Hepatic enzymes were abnormal in 4 cases, and myocardial enzymes were abnormal in5 cases. 8 patients had hypoxemia, with PaO2 less than 40 mmHg in5 cases. Chest X-ray films and CT showed double pneumonia in 9 patients. 9 patients were given oseltamivir antiviral treatment. 8 cases were given antibiotic therapy. 5 patients with bilateral severe pneumonia and respiratory failure were given corticosteriod therapy. 5 severe patients were treated with non-invasive ventilation. One case switched to invasive ventilation and eventually died. Conclusions Pregnant and postpartum women with influenzaH1N1 are likely to develop into severe condition which is commonly rapidlyprogressive and even life-threatening. The main causes of death are pneumonia and acute respiratory distress syndrome.