van Someren Gréve Frank, Juffermans Nicole P, Bos Lieuwe D J, Binnekade Jan M, Braber Annemarije, Cremer Olaf L, de Jonge Evert, Molenkamp Richard, Ong David S Y, Rebers Sjoerd P H, Spoelstra-de Man Angelique M E, van der Sluijs Koenraad F, Spronk Peter E, Verheul Kirsten D, de Waard Monique C, de Wilde Rob B P, Winters Tineke, de Jong Menno D, Schultz Marcus J
Department of Intensive Care, Academic Medical Center, Amsterdam, The Netherlands.
Department of Medical Microbiology, Academic Medical Center, Amsterdam, The Netherlands.
Crit Care Med. 2018 Jan;46(1):29-36. doi: 10.1097/CCM.0000000000002752.
The presence of respiratory viruses and the association with outcomes were assessed in invasively ventilated ICU patients, stratified by admission diagnosis.
Prospective observational study.
Five ICUs in the Netherlands.
Between September 1, 2013, and April 30, 2014, 1,407 acutely admitted and invasively ventilated patients were included.
None.
Nasopharyngeal swabs and tracheobronchial aspirates were collected upon intubation and tested for 14 respiratory viruses. Out of 1,407 patients, 156 were admitted because of a severe acute respiratory infection and 1,251 for other reasons (non-severe acute respiratory infection). Respiratory viruses were detected in 28.8% of severe acute respiratory infection patients and 17.0% in non-severe acute respiratory infection (p < 0.001). In one third, viruses were exclusively detected in tracheobronchial aspirates. Rhinovirus and human metapneumovirus were more prevalent in severe acute respiratory infection patients (9.6% and 2.6% vs 4.5 and 0.2%; p = 0.006 and p < 0.001). In both groups, there were no associations between the presence of viruses and the number of ICU-free days at day 28, crude mortality, and mortality in multivariate regression analyses.
Respiratory viruses are frequently detected in acutely admitted and invasively ventilated patients. Rhinovirus and human metapneumovirus are more frequently found in severe acute respiratory infection patients. Detection of respiratory viruses is not associated with worse clinically relevant outcomes in the studied cohort of patients.
在因入院诊断分层的有创通气重症监护病房（ICU）患者中评估呼吸道病毒的存在情况及其与预后的关联。
前瞻性观察性研究。
荷兰的五家ICU。
纳入了2013年9月1日至2014年4月30日期间1407例急性入院且接受有创通气的患者。
无。
插管时采集鼻咽拭子和气管支气管吸出物，检测14种呼吸道病毒。1407例患者中，156例因严重急性呼吸道感染入院，1251例因其他原因（非严重急性呼吸道感染）入院。严重急性呼吸道感染患者中28.8%检测到呼吸道病毒，非严重急性呼吸道感染患者中为17.0%（p<0.001）。三分之一的患者仅在气管支气管吸出物中检测到病毒。鼻病毒和人偏肺病毒在严重急性呼吸道感染患者中更常见（分别为9.6%和2.6%，而在非严重急性呼吸道感染患者中为4.5%和0.2%；p = 0.006和p<0.001）。在两组中，多因素回归分析显示病毒的存在与第28天无ICU天数、粗死亡率及死亡率之间均无关联。
在急性入院且接受有创通气的患者中经常检测到呼吸道病毒。鼻病毒和人偏肺病毒在严重急性呼吸道感染患者中更常见。在所研究的患者队列中，呼吸道病毒的检测与较差的临床相关预后无关。
