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腺病毒肺炎患儿的临床特征、重症监护需求及预后:来自印度北部一家三级护理医院的回顾性研究

Clinical Profile, Intensive Care Needs, and Outcome of Children with Adenoviral Pneumonia: A Retrospective Study from a Tertiary Care Hospital in North India.

作者信息

Vyasam Siva, Jayaram Jyothi, Sarkar Subhabrata, Angurana Suresh Kumar, Raj Shubham, Bora Ishani, Nallasamy Karthi, Bansal Arun, Muralidharan Jayashree, Ratho Radha K

机构信息

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.

出版信息

Indian J Crit Care Med. 2025 Jul;29(7):586-591. doi: 10.5005/jp-journals-10071-24999. Epub 2025 Jul 7.

Abstract

BACKGROUND AND AIMS

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.

PATIENTS AND METHODS

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.

RESULTS

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).

CONCLUSION

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.

HOW TO CITE THIS ARTICLE

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.

摘要

背景与目的

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。

患者与方法

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。

结果

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)。

结论

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。

如何引用本文

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。

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