Influenza management with new therapies.


Journal

Current opinion in pulmonary medicine
ISSN: 1531-6971
Titre abrégé: Curr Opin Pulm Med
Pays: United States
ID NLM: 9503765

Informations de publication

Date de publication:
05 2020
Historique:
pubmed: 19 2 2020
medline: 4 2 2021
entrez: 19 2 2020
Statut: ppublish

Résumé

Influenza represents a significant treatment burden to critical care services. A variety of treatment strategies exist, with more and more therapeutic avenues opening up as research progresses. We examined both pharmacological and supportive treatment strategies currently available to see how they might be applied in an ICU setting. Supportive care in Influenza centres around optimizing respiratory failure, particularly through well established and recognized ventilatory strategies. Noninvasive ventilation and high-flow nasal oxygen may have a limited role in selected patients under carefully monitored circumstances. Drug therapy exerts only a modest clinical effect and has been poorly studied in the critically ill, though there is some evidence to support the use of neuraminidase inhibitors (NAI) - particularly oseltamivir - as early as possible in this cohort. Newer agents have failed to demonstrate superiority over NAIs but may be useful options if the patient fails to respond or should resistant influenza strains emerge. Steroid therapy, in the absence of another indication, must be recommended against given the repeated trend towards increased mortality in this group. Influenza management is an evolving field of significant interest to any critical care provider. Currently, good respiratory supportive care and early enteral oseltamivir are the best supported treatment strategies. Further study in the intensive care setting will be needed before the use of novel agents can be recommended.

Identifiants

pubmed: 32068576
doi: 10.1097/MCP.0000000000000667
pii: 00063198-202005000-00006
doi:

Substances chimiques

Adrenal Cortex Hormones 0
Amides 0
Antiviral Agents 0
Dibenzothiepins 0
Enzyme Inhibitors 0
Morpholines 0
Pyrazines 0
Pyridines 0
Pyridones 0
Pyrimidines 0
Pyrroles 0
Triazines 0
Oseltamivir 20O93L6F9H
baloxavir 4G86Y4JT3F
pimodivir DFC121MXC3
Neuraminidase EC 3.2.1.18
favipiravir EW5GL2X7E0
Zanamivir L6O3XI777I

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

215-221

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Auteurs

Shane O'Sullivan (S)

Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St James Hospital, Dublin, Ireland.

Antoni Torres (A)

Department of Respiratory Medicine, Hospital Clinic, IDIBAPS, CIBERes, Barcelona.

Alejandro Rodriguez (A)

Department of Intensive Care Medicine, Hospital Joan XXIII, CIBERes, Tarragona, Spain.

Ignacio Martin-Loeches (I)

Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St James Hospital, Dublin, Ireland.
Department of Respiratory Medicine, Hospital Clinic, IDIBAPS, CIBERes, Barcelona.

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Classifications MeSH