Department of Pediatrics, Pediatric Critical Care Medicine, University of Alberta, Edmonton, AB, Canada.
School of Public Health, University of Alberta, Edmonton, AB, Canada.
Acta Paediatr. 2018 Mar;107(3):504-510. doi: 10.1111/apa.14148. Epub 2017 Dec 5.
To describe the epidemiology of critically ill children admitted to a paediatric intensive care unit (PICU) with acute respiratory disease. The association with intubation was analysed for the three most prevalent viruses and in those with and without viral co-infection.
Patients admitted to the PICU (2004-2014) with acute respiratory disease were included. Analyses were performed utilising each respiratory viral infection or multiple viral infections as an exposure.
There were 1766 admissions with acute respiratory disease of which 1372 had respiratory virus testing and 748 had one or more viruses detected. The risk of intubation before or during the PICU stay was higher if parainfluenza virus was detected compared to respiratory syncytial virus (RSV) (OR: 2.20; 95% CI: 1.06-4.56). Sixty-three admissions had two or more viruses detected, and the combination of RSV and Rhinovirus/enterovirus was the most common. No significant difference was observed in the risk of intubation between patients with multiple and single viral infections.
Higher risk of intubation was found in patients with parainfluenza as compared to RSV. The risk of intubation comparing parainfluenza virus to other viruses and for patients with multiple versus single virus needs to be further studied.
描述入住儿科重症监护病房（PICU）的急性呼吸疾病危重症患儿的流行病学特征。分析三种最常见病毒以及合并和不合并病毒合并感染患儿的气管插管情况。
纳入 2004 年至 2014 年期间入住 PICU 的急性呼吸疾病患儿。利用每种呼吸道病毒感染或多种病毒感染作为暴露进行分析。
共 1766 例急性呼吸疾病患儿入院，其中 1372 例进行了呼吸道病毒检测，748 例检测到一种或多种病毒。与呼吸道合胞病毒（RSV）相比，副流感病毒检测阳性患儿发生 PICU 入住前或入住期间气管插管的风险更高（OR：2.20；95%CI：1.06-4.56）。63 例患儿检测到两种或更多种病毒，其中 RSV 和鼻病毒/肠道病毒的组合最常见。在发生多重和单一病毒感染的患儿之间，气管插管的风险无显著差异。
与 RSV 相比，副流感病毒患儿发生气管插管的风险更高。需要进一步研究副流感病毒与其他病毒以及多重病毒感染与单一病毒感染患儿的气管插管风险。
