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Critical H1N1 in children unpredictable

BALTIMORE, Jan. 7 (UPI) -- A study of 13 children hospitalized with H1N1 found the patients survived but serious complications developed quickly and unpredictably, U.S. researchers say.

Lead investigator Justin Lockman, a pediatric critical-care specialist at Johns Hopkins Children's Center in Baltimore says although all of the 13 children survived, they required a serious need for vigilant monitoring and quick treatment adjustments.

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The analysis, published in the journal Pediatric Critical Care Medicine, shows that 12 of the 13 very ill children had underlying medical conditions that made them more vulnerable, including sickle cell disease, asthma and human immunodeficiency virus. Complications varied from temporary kidney failure to acute respiratory distress syndrome, dangerously low oxygen levels and dangerously low blood pressure.

An important finding was that rapid screening tests were initially negative in eight of the children, underscoring the need for more sensitive tests, the researchers say.

All critically ill children with flu-like symptoms, regardless of test results, should be treated pre-emptively with antiviral medications, the researchers say.

"Our most surprising, and perhaps most important finding, is that the H1N1 virus behaves unpredictably and variably from one patient to the other and even within the same patient from day to day, so we must be on our toes and react fast by adjusting therapy," Lockman said in a statement.

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