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.
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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引用次数: 0
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.
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.