Postelnicu Radu, Srivastava Avantika, Bhatraju Pavan K, Wurfelc Mark M, Anesi George L, Gonzalez Martin, Andrews Adair, Lutrick Karen, Kumar Vishakha K, Uyeki Timothy M, Cobb Perren J, Segal Leopoldo N, Brett-Major David, Liebler Janice M, Kratochvil Christopher J, Mukherjee Vikramjit, Broadhurst M Jana, Lee Richard, Wyles David, Sevransky Jonathan E, Evans Laura, Landsittel Douglas
Division of Pulmonary, Critical Care, and Sleep Medicine, NYU Grossman School of Medicine, NYU Langone Health, New York, NY.
Department of Biomedical Informatics, School of Medicine, University of Pittsburgh, Pittsburgh, PA.
Crit Care Explor. 2022 Oct 20;4(10):e0773. doi: 10.1097/CCE.0000000000000773. eCollection 2022 Oct.
Respiratory virus infections cause significant morbidity and mortality ranging from mild uncomplicated acute respiratory illness to severe complications, such as acute respiratory distress syndrome, multiple organ failure, and death during epidemics and pandemics. We present a protocol to systematically study patients with severe acute respiratory infection (SARI), including severe acute respiratory syndrome coronavirus 2, due to respiratory viral pathogens to evaluate the natural history, prognostic biomarkers, and characteristics, including hospital stress, associated with clinical outcomes and severity.
Prospective cohort study.
Multicenter cohort of patients admitted to an acute care ward or ICU from at least 15 hospitals representing diverse geographic regions across the United States.
Patients with SARI caused by infection with respiratory viruses that can cause outbreaks, epidemics, and pandemics.
None.
Measurements include patient demographics, signs, symptoms, and medications; microbiology, imaging, and associated tests; mechanical ventilation, hospital procedures, and other interventions; and clinical outcomes and hospital stress, with specimens collected on days 0, 3, and 7-14 after enrollment and at discharge. The primary outcome measure is the number of consecutive days alive and free of mechanical ventilation (VFD) in the first 30 days after hospital admission. Important secondary outcomes include organ failure-free days before acute kidney injury, shock, hepatic failure, disseminated intravascular coagulation, 28-day mortality, adaptive immunity, as well as immunologic and microbiologic outcomes.
SARI-Preparedness is a multicenter study under the collaboration of the Society of Critical Care Medicine Discovery, Resilience Intelligence Network, and National Emerging Special Pathogen Training and Education Center, which seeks to improve understanding of prognostic factors associated with worse outcomes and increased resource utilization. This can lead to interventions to mitigate the clinical impact of respiratory virus infections associated with SARI.
呼吸道病毒感染会导致显著的发病率和死亡率，范围从轻微的无并发症急性呼吸道疾病到严重并发症，如急性呼吸窘迫综合征、多器官衰竭，以及在流行和大流行期间导致死亡。我们提出了一项方案，用于系统研究因呼吸道病毒病原体导致的严重急性呼吸道感染（SARI）患者，包括严重急性呼吸综合征冠状病毒2，以评估自然病程、预后生物标志物以及与临床结局和严重程度相关的特征，包括医院压力。
前瞻性队列研究。
来自美国至少15家代表不同地理区域的医院的急性护理病房或重症监护病房收治患者的多中心队列。
由可引发暴发、流行和大流行的呼吸道病毒感染导致SARI的患者。
无。
测量指标包括患者人口统计学信息、体征、症状和用药情况；微生物学、影像学及相关检查；机械通气、医院诊疗程序及其他干预措施；以及临床结局和医院压力，在入组后第0天、第3天、第7 - 14天及出院时采集标本。主要结局指标是入院后前30天内连续存活且无需机械通气的天数（VFD）。重要的次要结局指标包括急性肾损伤、休克、肝衰竭、弥散性血管内凝血之前无器官衰竭的天数、28天死亡率、适应性免疫，以及免疫和微生物学结局。
SARI - Preparedness是一项由危重病医学会发现、恢复力情报网络和国家新兴特殊病原体培训与教育中心合作开展的多中心研究，旨在增进对与更差结局及资源利用增加相关的预后因素的理解。这可能会带来干预措施，以减轻与SARI相关的呼吸道病毒感染的临床影响。
