Severe flu management: a point of view

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Intensive Care Med. 2020 Jan 7. doi: 10.1007/s00134-019-05868-8. [Epub ahead of print] Severe flu management: a point of view.

Torres A¹, Loeches IM^2,3, Sligl W^4,5, Lee N⁴.
Author information

1 Service of Pneumology, Hospital Clinic of Barcelona, University of Barcelona, Institut d'Investigaci? August Pi i Sunyer (IDIBAPS) and Centro de Investigaci?n Biom?dica en Red, Enfermedades Respiratorias (CIBERES), C/Villarroel 170, 08036, Barcelona, Spain. atorres@clinic.cat. 2 Service of Pneumology, Hospital Clinic of Barcelona, University of Barcelona, Institut d'Investigaci? August Pi i Sunyer (IDIBAPS) and Centro de Investigaci?n Biom?dica en Red, Enfermedades Respiratorias (CIBERES), C/Villarroel 170, 08036, Barcelona, Spain. 3 Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St. James's Hospital, Dublin, Ireland. 4 Division of Infectious Diseases, Department of Medicine, University of Alberta, Edmonton, Canada. 5 Department of Critical Care Medicine, University of Alberta, Edmonton, Canada.

Abstract

Annual flu seasons are typically characterized by changes in types and subtypes of influenza, with variations in terms of severity. Despite remarkable improvements in the prevention and management of patients with suspected or laboratory-confirmed diagnosis of influenza, annual seasonal influenza continues to be associated with a high morbidity and mortality. Admission to the intensive care unit is required for patients with severe forms of seasonal influenza infection, with primary pneumonia being present in most of the cases. This review summarizes the most recent knowledge on the diagnosis and treatment strategies in critically ill patients with influenza, focused on diagnostic testing methods, antiviral therapy, use of corticosteroids, antibacterial and antifungal therapy, and supportive measures. The review focuses on diagnostic testing methods, antiviral therapy, use of corticosteroids, antibacterial and antifungal therapy, supportive measures and relevant existing evidence, in order to provide the non-expert clinician a useful overview. An enhanced understanding of current diagnostic and treatment aspects of influenza infection can contribute to improve outcomes and reduce mortality among ICU patients with influenza.


KEYWORDS:

Antivirals; Corticosteroids; ICU; Influenza; Mortality; Pneumonia

PMID: 31912206 DOI: 10.1007/s00134-019-05868-8