Is Clinical Outcome Pathogen Related? Characteristics and Outcomes of ICU Patients with Severe Acute Respiratory Infections: Focusing on Respiratory Syncytial Virus, Human Metapneumovirus, Influenza Virus, and Parainfluenza Virus.

IF 2.1 3区 医学 Q2 CRITICAL CARE MEDICINE
S van der Bie, R C Fluit, T Neijzen, S M Euser, E C M van Gorp, J Kalpoe, D Souverein, D Snijders, J Du Toit, A D M E Osterhaus, D Gommers, S F L van Lelyveld, M Goeijenbier
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Abstract

IntroductionViral severe acute respiratory infections (SARI) are a major cause of intensive care unit (ICU) admission, with a significant burden and mortality. Comparative clinical data of patients admitted to the ICU with virus infections other than SARS-CoV-2 or influenza virus (IV) infection are limited. Therefore, this study investigates patient characteristics, clinical outcomes, and ventilation parameters of ICU patients admitted with SARI caused by Respiratory syncytial virus (RSV), Human metapneumovirus (HMPV), IV, or Parainfluenza virus (PIV).MethodsA retrospective cohort study was conducted of patients with SARI admitted to the ICU of the Spaarne Gasthuis, a Dutch secondary teaching hospital, between 2017 and 2023.Results277 patients were included, with RSV (n = 51), HMPV (n = 40), IV (n = 142), and PIV (n = 44) infections respectively. Pre-existing hematological malignancies were more common in RSV patients. No significant differences were found in length of hospital stay or ventilation parameters across the respective virus groups. Median duration of ICU stay was four days (IQR 2-7). Bacterial co-infections, pulmonary infiltrates and a higher ROX-index were more common in patients with noninvasive ventilation (NIV) failure. Hospital mortality rates were not different between the groups; RSV (25.5%), HMPV (15%), IV (24.6%), and PIV (20.5%).ConclusionThis study analyzed ICU patients with SARI caused by HMPV, RSV, IV, or PIV, revealing four key findings: high ICU, hospital and 1 year mortality rates with no differences and similar mechanical ventilation parameters between the groups, risk factors for NIV failure linked to prolonged ventilation, and co-morbidities associated with severe disease.

临床结果与病原体有关吗?重症急性呼吸道感染ICU患者的特点和结局:以呼吸道合胞病毒、人偏肺病毒、流感病毒和副流感病毒为重点
病毒性严重急性呼吸道感染(SARI)是重症监护病房(ICU)入院的主要原因,具有显著的负担和死亡率。除SARS-CoV-2或流感病毒(IV)感染外,ICU入院的病毒感染患者的比较临床资料有限。因此,本研究调查了呼吸道合胞病毒(RSV)、人偏肺病毒(HMPV)、IV或副流感病毒(PIV)引起的急性呼吸道感染(SARI)住院ICU患者的患者特征、临床结局和通气参数。方法对2017 - 2023年荷兰二级教学医院Spaarne Gasthuis ICU收治的SARI患者进行回顾性队列研究。结果共纳入277例患者,其中RSV 51例,HMPV 40例,IV 142例,PIV 44例。先前存在的血液系统恶性肿瘤在RSV患者中更为常见。在不同的病毒组中,住院时间或通气参数没有发现显著差异。ICU住院时间中位数为4天(IQR 2-7)。细菌合并感染、肺部浸润和较高的rox指数在无创通气(NIV)失败患者中更为常见。两组之间的医院死亡率没有差异;RSV(25.5%)、HMPV (15%), IV(24.6%),和PIV(20.5%)。本研究分析了由HMPV、RSV、IV或PIV引起的重症监护室SARI患者,揭示了四个关键发现:ICU、医院和1年死亡率高,各组之间无差异,机械通气参数相似,NIV失效的危险因素与延长通气有关,以及与严重疾病相关的合并症。
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来源期刊
Journal of Intensive Care Medicine
Journal of Intensive Care Medicine CRITICAL CARE MEDICINE-
CiteScore
7.60
自引率
3.20%
发文量
107
期刊介绍: Journal of Intensive Care Medicine (JIC) is a peer-reviewed bi-monthly journal offering medical and surgical clinicians in adult and pediatric intensive care state-of-the-art, broad-based analytic reviews and updates, original articles, reports of large clinical series, techniques and procedures, topic-specific electronic resources, book reviews, and editorials on all aspects of intensive/critical/coronary care.
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