UMEM Educational Pearls

Category: Critical Care

Title: Influenza and the Critically Ill

Keywords: influenza, zanamivir, oseltamivir (PubMed Search)

Posted: 10/21/2008 by Mike Winters, MD (Updated: 8/11/2020)
Click here to contact Mike Winters, MD

 Influenza and the Critically Ill

  • It is that time of year again to be vigilant for cases of influenza
  • Influenza is not benign and causes > 40,000 deaths per year and is the 7th leading cause of death in the US
  • In the critically ill, the most severe disease occurs in patients > 65 and those with underlying cardiopulmonary disease
  • Critically ill patients with influenza can present with fever, cough, bilateral interstitial infiltrates, hypoxemia, and leukopenia
  • Other serious complications include myocarditis, encephalitis, and Reye syndrome
  • Amantadine and rimantadine should no longer be used, as the resistance has risen to > 90% in some populations
  • Oseltamivir (PO) and zanamivir (powder/inhalation) are the approved neuraminidase inhibitors; both decrease the severity and duration of illness; should be given as early as possible, preferably within 36 hours

 

 

 

 

 

 

 

 

References

 Beigel JH. Influenza. Crit Care Med 2008;36:2660-6.