The Internet Book of Critical Care Podcast IBCC Episode 19 - Severe Influenza
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Jan 10, 2019 Explore clinical management of severe influenza, including resuscitation, antibiotics, antiviral therapy, adjuvant therapy, and HLH. Learn about treatment options, misdiagnosis, and adjunct therapies like steroids, vitamin C, and NSAIDs. Understand hemophagocytic lymphohistiocytosis (HLH) and its link to viral infections. Discover treatment options for secondary infections in severe influenza and the importance of vigilance for post-flu pneumonia and HLH.
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Severe Influenza Presentation Insight
- Severe influenza often causes hypoxemia and abnormal chest X-rays but patients may initially appear less sick.
- Early vital signs like increased heart rate and respiratory rate are key indicators of severity.
Avoid Excess Fluids in Influenza
- Avoid giving large fluid volumes to patients with viral pneumonitis to prevent worsening lung function.
- Use vasopressors early if needed instead of following typical sepsis fluid resuscitation protocols.
Antibiotic Strategy for Influenza
- Include macrolides (especially chloramphenicol) in antibiotic regimens for influenza due to potential anti-influenza and anti-inflammatory effects.
- Add beta-lactams for typical pneumonia and cover MRSA with linezolid if risk factors exist.