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Viral etiology and outcome of severe lower respiratory tract infections among critically ill children admitted to the PICU
To determine the viral etiology of severe lower respiratory tract infections (LRTIs), their clinical significance and prognosis among critically ill children. A prospective descriptive study was carried out. Pediatric Intensive Care Unit (PICU) of Istanbul Medeniyet University, Goztepe Training and...
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| Published in: | Medicina intensiva 2021-11, Vol.45 (8), p.447-458 |
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| description | To determine the viral etiology of severe lower respiratory tract infections (LRTIs), their clinical significance and prognosis among critically ill children.
A prospective descriptive study was carried out.
Pediatric Intensive Care Unit (PICU) of Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey.
A total of 115 patients hospitalized in the PICU were evaluated for inclusion in the study. Children with underlying comorbidities and those who did not require mechanical ventilation were excluded.
Demographic, clinical, laboratory test and radiographic data were recorded.
A total of 63 patients were eligible for the study. The most common diagnosis was bronchiolitis (57.1%). Respiratory syncytial virus (RSV) was the most frequent causal virus (36.5%). The most common complication was acute respiratory distress syndrome (ARDS) (28.6%). Multiple viral infection was identified in 20.6% of the patients, the most common in this subgroup being rhinovirus. Patients with bocavirus infection had a higher likelihood of needing invasive mechanical ventilation (IMV) at presentation. Children who died were likely to be |
| doi_str_mv | 10.1016/j.medin.2020.04.023 |
| format | article |
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A prospective descriptive study was carried out.
Pediatric Intensive Care Unit (PICU) of Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey.
A total of 115 patients hospitalized in the PICU were evaluated for inclusion in the study. Children with underlying comorbidities and those who did not require mechanical ventilation were excluded.
Demographic, clinical, laboratory test and radiographic data were recorded.
A total of 63 patients were eligible for the study. The most common diagnosis was bronchiolitis (57.1%). Respiratory syncytial virus (RSV) was the most frequent causal virus (36.5%). The most common complication was acute respiratory distress syndrome (ARDS) (28.6%). Multiple viral infection was identified in 20.6% of the patients, the most common in this subgroup being rhinovirus. Patients with bocavirus infection had a higher likelihood of needing invasive mechanical ventilation (IMV) at presentation. Children who died were likely to be <12 months old, have ARDS, hepatitis, pneumomediastinum, multiple viral infection, and required IMV support with an increased duration of MV. Additionally, they were found to have a high Pediatric Risk of Mortality III score, Predicted Death Rate and increased need for inotropic support at admission.
Our study showed critically ill children with LRTI without known risk factors to have high mortality when aged <12 months, in the presence of multiple agents and when certain complications (ARDS, hepatitis) and X-ray findings were identified.
Determinar la etiología vírica de las infecciones graves de las vías respiratorias bajas (IGVRB), su importancia clínica y su pronóstico en niños críticamente enfermos.
Estudio descriptivo prospectivo.
Unidad de cuidados intensivos pediátricos (UCIP) del Hospital Universitario y de Investigación Goztepe, Universidad Medeniyet de Estambul, Turquía.
Se evaluó a un total de 115 pacientes ingresados en la UCIP para su posible inclusión en el estudio. Se excluyó a los niños con comorbilidades subyacentes y a aquellos que no requerían ventilación mecánica.
Se registraron los datos demográficos, clínicos, de laboratorio y radiológicos de los pacientes.
Un total de 63 pacientes fueron elegidos para participar en el estudio. El diagnóstico más habitual era bronquiolitis (57,1%). El virus sincitial respiratorio era el más común de los virus (36,5%). La complicación más habitual era el síndrome de dificultad respiratoria aguda (SDRA) (28,6%). Se identificaron múltiples infecciones víricas en el 20,6% de los pacientes, siendo la infección por el rinovirus la más común en este subgrupo. Los pacientes con infección por bocavirus presentaban una mayor probabilidad de necesitar ventilación mecánica invasiva (VMI) en el momento de la presentación. Los niños que murieron tenían una mayor probabilidad de presentar: edad <12 meses, SDRA, hepatitis, neumomediastino, infección multiviral y requerir MVI, con una mayor duración de la VM. Además, se observó que presentaban unos valores más altos de la escala PRISM III (Pediatric Risk of Mortality III) y tasa de mortalidad prevista, además de necesidad apoyo inotrópico en el momento del ingreso.
Nuestro estudio demostró que los niños críticamente enfermos con LRTI sin factores de riesgo conocidos tienen una alta mortalidad cuando tienen menos de 12 meses, en presencia de múltiples agentes y cuando se identifican ciertas complicaciones (SDRA, hepatitis) y hallazgos de rayos X.</description><identifier>ISSN: 0210-5691</identifier><identifier>EISSN: 2173-5727</identifier><identifier>EISSN: 1578-6749</identifier><identifier>DOI: 10.1016/j.medin.2020.04.023</identifier><identifier>PMID: 32405129</identifier><language>eng</language><publisher>Spain: Elsevier España, S.L.U</publisher><subject>Acute lower respiratory tract infections ; Children ; Etiología viral ; Infecciones agudas del tracto respiratorio inferior ; Mechanical ventilation ; Niños ; Pediatric intensive care unit ; Unidad de cuidados intensivos pediátricos ; Ventilación mecánica ; Viral etiology</subject><ispartof>Medicina intensiva, 2021-11, Vol.45 (8), p.447-458</ispartof><rights>2020 Elsevier España, S.L.U. y SEMICYUC</rights><rights>2020 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.</rights><rights>2020 Elsevier España, S.L.U. y SEMICYUC. All rights reserved. 2020 Elsevier España, S.L.U. y SEMICYUC</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3743-7d3985c793677786a9aa86d07081876b2346996f2a0291e725e46a1173b79a203</citedby><cites>FETCH-LOGICAL-c3743-7d3985c793677786a9aa86d07081876b2346996f2a0291e725e46a1173b79a203</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32405129$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Duyu, M.</creatorcontrib><creatorcontrib>Karakaya, Z.</creatorcontrib><title>Viral etiology and outcome of severe lower respiratory tract infections among critically ill children admitted to the PICU</title><title>Medicina intensiva</title><addtitle>Med Intensiva (Engl Ed)</addtitle><description>To determine the viral etiology of severe lower respiratory tract infections (LRTIs), their clinical significance and prognosis among critically ill children.
A prospective descriptive study was carried out.
Pediatric Intensive Care Unit (PICU) of Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey.
A total of 115 patients hospitalized in the PICU were evaluated for inclusion in the study. Children with underlying comorbidities and those who did not require mechanical ventilation were excluded.
Demographic, clinical, laboratory test and radiographic data were recorded.
A total of 63 patients were eligible for the study. The most common diagnosis was bronchiolitis (57.1%). Respiratory syncytial virus (RSV) was the most frequent causal virus (36.5%). The most common complication was acute respiratory distress syndrome (ARDS) (28.6%). Multiple viral infection was identified in 20.6% of the patients, the most common in this subgroup being rhinovirus. Patients with bocavirus infection had a higher likelihood of needing invasive mechanical ventilation (IMV) at presentation. Children who died were likely to be <12 months old, have ARDS, hepatitis, pneumomediastinum, multiple viral infection, and required IMV support with an increased duration of MV. Additionally, they were found to have a high Pediatric Risk of Mortality III score, Predicted Death Rate and increased need for inotropic support at admission.
Our study showed critically ill children with LRTI without known risk factors to have high mortality when aged <12 months, in the presence of multiple agents and when certain complications (ARDS, hepatitis) and X-ray findings were identified.
Determinar la etiología vírica de las infecciones graves de las vías respiratorias bajas (IGVRB), su importancia clínica y su pronóstico en niños críticamente enfermos.
Estudio descriptivo prospectivo.
Unidad de cuidados intensivos pediátricos (UCIP) del Hospital Universitario y de Investigación Goztepe, Universidad Medeniyet de Estambul, Turquía.
Se evaluó a un total de 115 pacientes ingresados en la UCIP para su posible inclusión en el estudio. Se excluyó a los niños con comorbilidades subyacentes y a aquellos que no requerían ventilación mecánica.
Se registraron los datos demográficos, clínicos, de laboratorio y radiológicos de los pacientes.
Un total de 63 pacientes fueron elegidos para participar en el estudio. El diagnóstico más habitual era bronquiolitis (57,1%). El virus sincitial respiratorio era el más común de los virus (36,5%). La complicación más habitual era el síndrome de dificultad respiratoria aguda (SDRA) (28,6%). Se identificaron múltiples infecciones víricas en el 20,6% de los pacientes, siendo la infección por el rinovirus la más común en este subgrupo. Los pacientes con infección por bocavirus presentaban una mayor probabilidad de necesitar ventilación mecánica invasiva (VMI) en el momento de la presentación. Los niños que murieron tenían una mayor probabilidad de presentar: edad <12 meses, SDRA, hepatitis, neumomediastino, infección multiviral y requerir MVI, con una mayor duración de la VM. Además, se observó que presentaban unos valores más altos de la escala PRISM III (Pediatric Risk of Mortality III) y tasa de mortalidad prevista, además de necesidad apoyo inotrópico en el momento del ingreso.
Nuestro estudio demostró que los niños críticamente enfermos con LRTI sin factores de riesgo conocidos tienen una alta mortalidad cuando tienen menos de 12 meses, en presencia de múltiples agentes y cuando se identifican ciertas complicaciones (SDRA, hepatitis) y hallazgos de rayos X.</description><subject>Acute lower respiratory tract infections</subject><subject>Children</subject><subject>Etiología viral</subject><subject>Infecciones agudas del tracto respiratorio inferior</subject><subject>Mechanical ventilation</subject><subject>Niños</subject><subject>Pediatric intensive care unit</subject><subject>Unidad de cuidados intensivos pediátricos</subject><subject>Ventilación mecánica</subject><subject>Viral etiology</subject><issn>0210-5691</issn><issn>2173-5727</issn><issn>1578-6749</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kU2PEyEYx4nRuHX1E5gYjl5mfICZYThoYhpfNtlED65XQpmnLQ0DFWg39dPL2nWjF08c-L88-f8IecmgZcCGN7t2xsmFlgOHFroWuHhEFpxJ0fSSy8dkAZxB0w-KXZBnOe8AeK86eEouBO-gZ1wtyM_vLhlPsbjo4-ZETZhoPBQbZ6RxTTMeMSH18RYTTZj3VV1iOtGSjC3UhTXaag2ZmjmGDbXJFWeN9yfqvKd26_yUMFAzza4UnGiJtGyRfr1a3jwnT9bGZ3xx_16Sm48fvi0_N9dfPl0t3183VshONHISauytVGKQUo6DUcaMwwQSRjbKYcVFNyg1rLkBrhhK3mM3GFZnWEllOIhL8u6cuz-s6mIWQz3e631ys0knHY3T__4Et9WbeNSSs7GW1oDX9wEp_jhgLnp22aL3JmA8ZF3HFMDHUfIqFWepTTHnhOuHGgb6jpre6d_U9B01DZ2u1Krr1d8XPnj-YKqCt2cB1p2ODpPO1mGwNSlVAHqK7r8FvwCLh6r1</recordid><startdate>20211101</startdate><enddate>20211101</enddate><creator>Duyu, M.</creator><creator>Karakaya, Z.</creator><general>Elsevier España, S.L.U</general><general>Elsevier España, S.L.U. y SEMICYUC</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20211101</creationdate><title>Viral etiology and outcome of severe lower respiratory tract infections among critically ill children admitted to the PICU</title><author>Duyu, M. ; Karakaya, Z.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3743-7d3985c793677786a9aa86d07081876b2346996f2a0291e725e46a1173b79a203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Acute lower respiratory tract infections</topic><topic>Children</topic><topic>Etiología viral</topic><topic>Infecciones agudas del tracto respiratorio inferior</topic><topic>Mechanical ventilation</topic><topic>Niños</topic><topic>Pediatric intensive care unit</topic><topic>Unidad de cuidados intensivos pediátricos</topic><topic>Ventilación mecánica</topic><topic>Viral etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Duyu, M.</creatorcontrib><creatorcontrib>Karakaya, Z.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medicina intensiva</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Duyu, M.</au><au>Karakaya, Z.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Viral etiology and outcome of severe lower respiratory tract infections among critically ill children admitted to the PICU</atitle><jtitle>Medicina intensiva</jtitle><addtitle>Med Intensiva (Engl Ed)</addtitle><date>2021-11-01</date><risdate>2021</risdate><volume>45</volume><issue>8</issue><spage>447</spage><epage>458</epage><pages>447-458</pages><issn>0210-5691</issn><eissn>2173-5727</eissn><eissn>1578-6749</eissn><abstract>To determine the viral etiology of severe lower respiratory tract infections (LRTIs), their clinical significance and prognosis among critically ill children.
A prospective descriptive study was carried out.
Pediatric Intensive Care Unit (PICU) of Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey.
A total of 115 patients hospitalized in the PICU were evaluated for inclusion in the study. Children with underlying comorbidities and those who did not require mechanical ventilation were excluded.
Demographic, clinical, laboratory test and radiographic data were recorded.
A total of 63 patients were eligible for the study. The most common diagnosis was bronchiolitis (57.1%). Respiratory syncytial virus (RSV) was the most frequent causal virus (36.5%). The most common complication was acute respiratory distress syndrome (ARDS) (28.6%). Multiple viral infection was identified in 20.6% of the patients, the most common in this subgroup being rhinovirus. Patients with bocavirus infection had a higher likelihood of needing invasive mechanical ventilation (IMV) at presentation. Children who died were likely to be <12 months old, have ARDS, hepatitis, pneumomediastinum, multiple viral infection, and required IMV support with an increased duration of MV. Additionally, they were found to have a high Pediatric Risk of Mortality III score, Predicted Death Rate and increased need for inotropic support at admission.
Our study showed critically ill children with LRTI without known risk factors to have high mortality when aged <12 months, in the presence of multiple agents and when certain complications (ARDS, hepatitis) and X-ray findings were identified.
Determinar la etiología vírica de las infecciones graves de las vías respiratorias bajas (IGVRB), su importancia clínica y su pronóstico en niños críticamente enfermos.
Estudio descriptivo prospectivo.
Unidad de cuidados intensivos pediátricos (UCIP) del Hospital Universitario y de Investigación Goztepe, Universidad Medeniyet de Estambul, Turquía.
Se evaluó a un total de 115 pacientes ingresados en la UCIP para su posible inclusión en el estudio. Se excluyó a los niños con comorbilidades subyacentes y a aquellos que no requerían ventilación mecánica.
Se registraron los datos demográficos, clínicos, de laboratorio y radiológicos de los pacientes.
Un total de 63 pacientes fueron elegidos para participar en el estudio. El diagnóstico más habitual era bronquiolitis (57,1%). El virus sincitial respiratorio era el más común de los virus (36,5%). La complicación más habitual era el síndrome de dificultad respiratoria aguda (SDRA) (28,6%). Se identificaron múltiples infecciones víricas en el 20,6% de los pacientes, siendo la infección por el rinovirus la más común en este subgrupo. Los pacientes con infección por bocavirus presentaban una mayor probabilidad de necesitar ventilación mecánica invasiva (VMI) en el momento de la presentación. Los niños que murieron tenían una mayor probabilidad de presentar: edad <12 meses, SDRA, hepatitis, neumomediastino, infección multiviral y requerir MVI, con una mayor duración de la VM. Además, se observó que presentaban unos valores más altos de la escala PRISM III (Pediatric Risk of Mortality III) y tasa de mortalidad prevista, además de necesidad apoyo inotrópico en el momento del ingreso.
Nuestro estudio demostró que los niños críticamente enfermos con LRTI sin factores de riesgo conocidos tienen una alta mortalidad cuando tienen menos de 12 meses, en presencia de múltiples agentes y cuando se identifican ciertas complicaciones (SDRA, hepatitis) y hallazgos de rayos X.</abstract><cop>Spain</cop><pub>Elsevier España, S.L.U</pub><pmid>32405129</pmid><doi>10.1016/j.medin.2020.04.023</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Medicina intensiva, 2021-11, Vol.45 (8), p.447-458 |
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| subjects | Acute lower respiratory tract infections Children Etiología viral Infecciones agudas del tracto respiratorio inferior Mechanical ventilation Niños Pediatric intensive care unit Unidad de cuidados intensivos pediátricos Ventilación mecánica Viral etiology |
| title | Viral etiology and outcome of severe lower respiratory tract infections among critically ill children admitted to the PICU |
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