Vyasam Siva, Jayaram Jyothi, Sarkar Subhabrata, Angurana Suresh Kumar, Raj Shubham, Bora Ishani, Nallasamy Karthi, Bansal Arun, Muralidharan Jayashree, Ratho Radha K
Department of Pediatrics, Advanced Pediatrics Centre; Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Department of Virology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Indian J Crit Care Med. 2025 Jul;29(7):586-591. doi: 10.5005/jp-journals-10071-24999. Epub 2025 Jul 7.
Adenoviral pneumonia is a significant cause of morbidity and mortality among children. There is limited data about the clinical profile, intensive care needs, and outcomes of children with adenoviral pneumonia from resource-limited settings.
This retrospective study was conducted in the pediatric emergency room (PER) and pediatric intensive care unit (PICU) of a tertiary care hospital in North India over a period of a period of 2 years (July 2022 to June 2024). The data collection included demographic and clinical features, laboratory investigations, complications, treatment, intensive care needs, and outcomes.
Eighty-five children were enrolled, majority were <1 year of age and males (71.7% each). All presented with fever and respiratory symptoms. The common complications were acute respiratory distress syndrome (ARDS) (47%), multiple organ dysfunction syndrome (MODS) (26%), shock (25%), and encephalopathy (25%). PICU admission was needed in 46% of children. The intensive care needs included invasive mechanical ventilation (48%), CPAP (39%), HFNC (9%), vasoactive drugs (25%), IVIG (8%), RRT (6%), and cidofovir (5%). The duration of ER, PICU, and hospital stay was 48 (24-96) hours, 7 (4-14) days, and 9 (5-18) days, respectively. The mortality rate was 22%. On multivariate analysis, the independent predictors of mortality were low admission pH, myocardial dysfunction, acute kidney (AKI), ARDS, shock, encephalopathy, MODS, and healthcare-associated infection (HCAI).
Infants constituted the largest group of patients requiring admission for adenoviral infection to pediatric emergency in a tertiary care center. Common complications were ARDS, shock, MODS, and encephalopathy. Nearly half required PICU admission for organ support. The mortality rate was 22%; and low admission pH, myocardial dysfunction, AKI, ARDS, shock, encephalopathy, MODS, and HCAI were independent predictors of mortality.
Vyasam S, Jayaram J, Sarkar S, Angurana SK, Raj S, Bora I, . Clinical Profile, Intensive Care Needs, and Outcome of Children with Adenoviral Pneumonia: A Retrospective Study from a Tertiary Care Hospital in North India. Indian J Crit Care Med 2025;29(7):586-591.
腺病毒性肺炎是儿童发病和死亡的重要原因。来自资源有限地区的儿童腺病毒性肺炎的临床特征、重症监护需求和预后的数据有限。
这项回顾性研究在印度北部一家三级医院的儿科急诊室(PER)和儿科重症监护病房(PICU)进行,为期2年(2022年7月至2024年6月)。数据收集包括人口统计学和临床特征、实验室检查、并发症、治疗、重症监护需求和预后。
共纳入85名儿童,大多数年龄小于1岁且为男性(各占71.7%)。所有患儿均有发热和呼吸道症状。常见并发症为急性呼吸窘迫综合征(ARDS)(47%)、多器官功能障碍综合征(MODS)(26%)、休克(25%)和脑病(25%)。46%的儿童需要入住PICU。重症监护需求包括有创机械通气(48%)、持续气道正压通气(CPAP)(39%)、高流量鼻导管吸氧(HFNC)(9%)、血管活性药物(25%)、静脉注射免疫球蛋白(IVIG)(8%)、肾脏替代治疗(RRT)(6%)和西多福韦(5%)。急诊室、PICU和住院时间分别为48(24 - 96)小时、7(4 - 14)天和9(5 - 18)天。死亡率为22%。多因素分析显示,死亡率的独立预测因素为入院时低pH值、心肌功能障碍、急性肾损伤(AKI)、ARDS、休克、脑病、MODS和医疗相关感染(HCAI)。
婴儿是三级医疗中心因腺病毒感染入住儿科急诊的最大患者群体。常见并发症为ARDS、休克、MODS和脑病。近一半患儿需要入住PICU进行器官支持。死亡率为22%;入院时低pH值、心肌功能障碍、AKI、ARDS、休克、脑病、MODS和HCAI是死亡率的独立预测因素。
Vyasam S, Jayaram J, Sarkar S, Angurana SK, Raj S, Bora I, . 儿童腺病毒性肺炎的临床特征、重症监护需求和预后:来自印度北部一家三级医院的回顾性研究。《印度重症医学杂志》2025;29(7):586 - 591。