influenza
INFLUENZA
The clinical spectrum of influenza ranges from asymptomatic infection to primary viral pneumonia that may progress to death.
Patients presenting with influenza-like illness (ie temperature of 37.8ºC, cough and/or sore throat and absence of a known cause other than influenza) might be infected with different types of influenza virus [eg avian influenza (H5N1)] as well as other respiratory pathogens.
A high index of suspicion is needed to recognize influenza in hospitalized patients.
Pneumonia is the most common complication of influenza virus.

Supportive Therapy for Hospitalized Patients

O2 Therapy

  • Administer O2 by face mask rather than nasal prongs

Continuous O2 therapy is Indicated for:

  • Patient with PaO2 <80 mmHg
  • Hypotension
  • Metabolic acidosis with bicarbonate <18 mmol/L
  • Respiratory distress with respiratory rate >24 breaths/minute

Goal of O2 Therapy

  •  Maintain >80 mmHg PaO2 and >90% SaO2 (95% for pregnant women)

Cautions

  •  Use of nebulizers and high air-flow O2 masks have been potentially implicated in the nosocomial spread of severe acute respiratory syndrome
    •  Use these measures only if clinically justified and apply them under strict infection control including airborne transmission precautions

 Hydration and Nutrition

  •  Assess for volume depletion
  •  Administer IV fluids if necessary
  •  Patients who are hospitalized for prolonged periods may require increased nutritional support (enteral, parenteral)
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