Influenza management with new therapies

Area of Science:

• Critical care medicine
• Infectious diseases
• Pulmonology

Background:

• Influenza poses a significant treatment challenge for critical care services.
• Evolving research is expanding therapeutic options for severe influenza.

Purpose of the Study:

• To review current pharmacological and supportive treatment strategies for influenza in the intensive care unit (ICU).
• To assess the applicability of existing treatments in an ICU setting.

Main Methods:

• Review of existing pharmacological and supportive treatment strategies for influenza.
• Evaluation of their potential application in critical care.

Main Results:

• Supportive care focuses on managing respiratory failure with ventilatory strategies.
• Neuraminidase inhibitors (NAIs), particularly oseltamivir, show modest benefit when given early.
• Steroid therapy is not recommended due to increased mortality.
• Newer agents may be useful for resistant strains or treatment failure.
• Noninvasive ventilation and high-flow nasal oxygen have limited roles.

Conclusions:

• Optimal respiratory supportive care and early enteral oseltamivir are the most evidence-based treatments for critical influenza.
• Further research is required to establish the role of novel agents in the ICU.