Treatment of Influenzal Pneumonia by Citrated Transfusions

Brown, W. L.; Sweet, B. L.

doi:10.1001/jama.1918.02600450078022

Cited by 5 publications

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“…Most excluded studies (Appendix Table, available at www.annals.org) reported that use of influenza-convalescent blood products was beneficial (27)(28)(29)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43). One large study at a U.S. Army recruit training hospital investigated the use of influenza-convalescent serum in patients with Spanish influenza but not pneumonia (27).…”

Section: Data From Excluded Studiesmentioning

confidence: 99%

“…No included study was identified solely from the citation review. We excluded 17 articles that were small case reports, were incomplete or noninterpretable, were written in a non-English language, or involved only patients with uncomplicated influenza (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43). Tables 1 and 2 show details from these studies, which ranged in size from 43 to 551 patients.…”

Section: Study Selection and Evaluationmentioning

confidence: 99%

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Meta-Analysis: Convalescent Blood Products for Spanish Influenza Pneumonia: A Future H5N1 Treatment?

et al. 2006

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Background: Studies from the Spanish influenza era reported that transfusion of influenza-convalescent human blood products reduced mortality in patients with influenza complicated by pneumonia. Treatments for H5N1 influenza are unsatisfactory, and convalescent human plasma containing H5N1 antibodies could be an effective therapy during outbreaks and pandemics.Purpose: To determine whether transfusion with influenza-convalescent human blood products reduced the risk for death in patients with Spanish influenza pneumonia.Data Sources: Manual search of English-language journals from 1918 to 1925. Citations from retrieved studies were also searched.Study Selection: Published English-language studies that had at least 10 patients in the treatment group, used convalescent blood products to treat Spanish influenza pneumonia in a hospital setting, and reported on a control or comparison group. Data Extraction:Two investigators independently extracted data on study characteristics, outcomes, adverse events, and quality. Data Synthesis: Eight relevant studies involving 1703 patients were found. Treated patients, who were often selected because of more severe illness, were compared with untreated controls with influenza pneumonia in the same hospital or ward. The overall crude case-fatality rate was 16% (54 of 336) among treated patients and 37% (452 of 1219) among controls. The range of absolute risk differences in mortality between the treatment and control groups was 8% to 26% (pooled risk difference, 21% [95% CI, 15% to 27%]). The overall crude case-fatality rate was 19% (28 of 148) among patients who received early treatment (after Ͻ4 days of pneumonia complications) and 59% (49 of 83) among patients who received late treatment (after Ն4 days of pneumonia complications). The range of absolute risk differences in mortality between the early treatment group and the late treatment group was 26% to 50% (pooled risk difference, 41% [CI, 29% to 54%]). Adverse effects included chill reactions and possible exacerbations of symptoms in a few patients.Limitations: Studies were few and had many methodologic limitations. No study was a blinded, randomized, or placebo-controlled trial. Some pertinent studies may have been missed. Conclusions:Patients with Spanish influenza pneumonia who received influenza-convalescent human blood products may have experienced a clinically important reduction in the risk for death. Convalescent human H5N1 plasma could be an effective, timely, and widely available treatment that should be studied in clinical trials.Ann Intern Med. 2006;145:599-609. www.annals.org For author affiliations, see end of text. The world is bracing for a potential H5N1 influenza pandemic. During the Spanish influenza pandemic, an estimated 30% of the world's population became ill and 50 million people died (1). An H5N1 influenza pandemic could be equally or more severe. Unfortunately, effective vaccines will be difficult to produce before a novel human pandemic strain emerges and will take substantial time to manufactur...

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Section: Data From Excluded Studiesmentioning

confidence: 99%

Section: Study Selection and Evaluationmentioning

confidence: 99%

Meta-Analysis: Convalescent Blood Products for Spanish Influenza Pneumonia: A Future H5N1 Treatment?

et al. 2006

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Citrated Blood in Treatment of the Pneumonia Following Influenza

Maclachlan¹,

Fetter²

1918

JAMA

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hemorrhagica that developed spontaneously as the result of injury. Furthermore, during this treatment with these vac¬ cines the occurrence of spontaneous purpura took place with less frequency until finally it disappeared after about three weeks' treatment, and the patient has been free from it ever since.Following this treatment the patient was referred to Dr. Endicott for surgical treatment. He successfully removed the right kidney, and the operation was followed by a complete recovery.

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Treatment of Influenza-Pneumonia by Use of Convalescent Human Serum

Redden¹

1919

The Boston Medical and Surgical Journal

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Treatment of Influenzal Pneumonia by Citrated Transfusions

Cited by 5 publications

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Meta-Analysis: Convalescent Blood Products for Spanish Influenza Pneumonia: A Future H5N1 Treatment?

Meta-Analysis: Convalescent Blood Products for Spanish Influenza Pneumonia: A Future H5N1 Treatment?

Citrated Blood in Treatment of the Pneumonia Following Influenza

Treatment of Influenza-Pneumonia by Use of Convalescent Human Serum

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