Influenza or other respiratory viruses: does it matter as the cause of acute respiratory failure in the critically-ill patients?

Introduction: Respiratory virus infections may cause serious respiratory failure requiring intensive care unit (ICU) admission. The objective of this study was to evaluate the clinical features and the outcome in patients with acute respi-ratory failure (ARF) due to viral infections comparing etiological agents.Materials and Methods: ARF patients with positive viral serology were retros-pectively recruited. Cohort was evaluated with regard to subgroups as influ-enza and other respiratory viruses (ORV), as well as survivors and non-survivors.Results: Out of 938 admitted patients, 319 were followed as ARF and only 149 patients had viral respiratory panel results. In 49 patients with ARF, 52 positive viral results were detected and 47 patients with single positive viral isolates of either influenza or ORV were included. Among them, 62% had ORV with quite similar characteristics with influenza group apart from diabe-tes mellitus which was encountered more in influenza group (p= 0.02). Overall ICU mortality was 32% and there was no difference between the two groups (p= 0.42). Acute Physiology and Chronic Health Evaluation (APACHE) II score was independently associated with ICU mortality (OR: 1.25; 95% CI: 1.04-1.51; p= 0.02). Conclusion: This study emphasizes to consider the possibility of other respiratory viruses for the cause of ARF with similar characte-ristics and mortality as influenza species.

İnfluenza veya diğer solunum yolu virüsleri: kritik hastalarda akut solunum yetmezliğinin sebebi olarak önemli midir?

Giriş: Solunum yolu virüsleri yoğun bakım ünitesi yatışı gerektiren ciddi solunum yetmezliğine neden olabilir. Bu çalışmanın amacı, viral enfeksiyonlara bağlı akut solunum yetmezliği (ASY) olan hastalarda etiyolojik ajanları karşılaştırmak, klinik özellikleri ve sonuç-ları değerlendirmektir.Materyal ve Metod: Viral serolojisi pozitif olan ASY hastaları geriye dönük olarak değerlendirildi. Kohort, influenza ve diğer solunum virüsleri (DSV), sağ kalanlar ve kaybedilenler olarak alt gruplara ayrılarak incelendi.Bulgular: Kabul edilen 938 hastanın 319’u ASY olarak takip edildi ve sadece 149 hastanın viral solunum paneli sonuçları mevcuttu. ASY’li 49 hastanın 52 pozitif viral sonucu tespit edildi ve influenza veya DSV’den tek pozitif viral izolatı olan 47 hasta çalışmaya dahil edildi. Bu hastaların %62’sini influenza grubu ile benzer özelliklere sahip DSV oluşturmaktaydı. Sadece diyabet mellitus influenza grubunda DSV grubuna göre daha fazla görüldü (p= 0.02). Toplam YBÜ mortalitesi %32 idi ve iki grup arasında mortalite açısından fark yoktu (p= 0.42). Akut Fizyoloji ve Kronik Sağlık Değerlendirmesi (APACHE) II skoru bağımsız olarak YBÜ mortalitesi ile ilişkili bulundu (OR: 1.25; %95 GA: 1.04-1.51; p= 0.02).Sonuç: Bu çalışma, ASY nedeni için influenza ile benzer özelliklere ve mortaliteye sahip diğer solunum virüsleri olasılığının düşünül-mesi gerektiğini vurgulamaktadır.

___

1. Nicholson KG, Wood JM, Zambon M. Influenza. Lancet 2003; 362: 1733-45.

2. ANZIC Influenza Investigators. Critical care services and 2009 H1N1 influenza in Australia and New Zealand. N Engl J Med 2009; 361(20): 1925-34.

3. Daubin C, Parienti JJ, Vincent S, Vabret A, du Cheyron D, Ramakers M, et al. Epidemiology and clinical outcome of virus-positive respiratory samples in ventilated patients: a prospective cohort study. Crit Care 2006; 10(5): R142.

4. Wiemken T, Peyrani P, Bryant K, Kelley RR, Summersgill J, Arnold F, et al. Incidence of respiratory viruses in patients with community-acquired pneumonia admitted to the intensive care unit: results from the Severe Influenza Pneumonia Surveillance (SIPS) project. Eur J Clin Microbiol Infect Dis 2013; 32(5): 705-10.

5. Choi SH, Hong SB, Ko GB, Lee Y, Park HJ, Park SY, et al. Viral infection in patients with severe pneumonia requiring intensive care unit admission. Am J Respir Crit Care Med 2012; 186(4): 325-32.

6. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987; 40(5): 373-83.

7. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med 1985; 13 (10): 818-29.

8. Vincent JL, Moreno R, Takala J, Willatts S, De Mendonça A, Bruining H, et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Med 1996; 22: 707–10.

9. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA 2016; 315(8): 801-10.

10. ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, Fan E, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA 2012; 307(23): 2526-33.

11. Schnell D, Gits-Muselli M, Canet E, Lemiale V, Schlemmer B, Simon F, et al. Burden of respiratory viruses in patients with acute respiratory failure. J Med Virol 2014; 86 (7): 198-202.

12. Rice TW, Rubinson L, Uyeki TM, Vaughn FL, John BB, Miller RR, et al. Critical illness from 2009 pandemic influenza A virus and bacterial coinfection in the United States. Crit Care Med 2012; 40: 1487–98.

13. Martín-Loeches I, Sanchez-Corral A, Diaz E, Granada RM, Zaragoza R, Villavicencio C, et al. Community-acquired respiratory coinfection in critically ill patients with pandemic 2009 influenza A(H1N1) virus. Chest 2011; 139: 555–62.

14. Visseaux B, Burdet C, Voiriot G, Lescure FX, Chougar T, Brugière O, et al. Prevalence of respiratory viruses among adults, by season, age, respiratory tract region and type of medical unit in Paris, France, from 2011 to 2016. PLos One 2017 Jul 14; 12(7): e0180888.

15. van Someren Gréve F, Schultz MJ, de Jong MD, Juffermans NP. Influenza and other respiratory viruses are underdiagnosed in critically ill patients. Crit Care Med 2015; 43 (4): e117.

16. Klekotka RB, Mizgała E, Król W. The etiology of lower respiratory tract infections in people with diabetes. Pneumonol Alergol Pol 2015; 83(5): 401-8.

17. Rodríguez-Valero M, Prado Calleros HM, Bravo Escobar GA, Valdez Vázquez RR, Figueroa Moreno R, Martínez Montes G, et al. Difference between early clinical features of swine origin A H1N1 influenza confirmed and not confirmed infection in Mexico. J Infect Dev Ctries 2012; 6 (4): 302-10.

18. Jain S, Kamimoto L, Bramley AM, Schmitz AM, Benoit SR, Louie J, et al. Hospitalized patients with 2009 H1N1 influenza in the United States, April-June 2009. N Engl J Med 2009; 12: 1935-44.

19. Miller AC, Subranian RA, Safi F, Sinert R, Zehtabchi S, Elamin EM. Influenza A 2009 (H1N1) virus in admitted and critically ill patients. J Intensive Care Med 2011; 27: 25–31.

20. Shorr AF, Fisher K, Micek ST, Kollef MH. The Burden of Viruses in Pneumonia Associated With Acute Respiratory Failure: An Underappreciated Issue. Chest 2017; pii: S0012-3692(17)33236-1.

21. Gilbert DN. Procalcitonin as a biomarker in respiratory tract infection. Clin Infect Dis 2011; 52(suppl 4): 346-50.

22. Self WH, Grijalva CG, Williams DJ, Woodworth A, Balk RA, Fakhran S, et al. Procalcitonin as an early marker of the need for invasive respiratory or vasopressor support in adults with community-acquired pneumonia. Chest 2016; 150(4): 819-28.

23. Fiore AE, Fry A, Shay D, Gubareva L, Bresee JS, Uyeki TM, Centers for Disease Control and Prevention (CDC). Antiviral agents for the treatment and chemoprophylaxis of influenza-recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2011; 60: 1–24.

24. Dawood FS, Iuliano AD, Reed C, Meltzer MI, Shay DK, Cheng PY, et al. Estimated global mortality associated with the first 12 months of 2009 pandemic influenza A H1N1 virus circulation: a modelling study. Lancet Infect Dis 2012; 12(9): 687-95.

25. Dimopoulos G, Lerikou M, Tsiodras S, Chranioti A, Perros E, Anagnostopoulou U, et al. Viral epidemiology of acute exacerbations of chronic obstructive pulmonary disease. Pulm Pharmacol Ther 2012 Feb; 25(1): 12-8.

26. Proud D, Naclerio RM, Gwaltney JM, Hendley JO. Kinins are generated in nasal secretions during natural rhinovirus colds. J Infect Dis 1990; 161(1): 120-3.

27. Kraft CS, Jacob JT, Sears MH, Burd EM, Caliendo AM, Lyon GM. Severity of human rhinovirus infection in immunocompromised adults is similar to that of 2009 H1N1 influenza. J Clin Microbiol 2012; 50(3): 1061-3.

28. Falsey AR, Walsh EE. Respiratory syncytial virus infection in adults. Clin Microbiol Rev 2000; 13(3): 371-84.

29. Puig-Barberà J, Tormos A, Sominina A, Burtseva E, Launay O, Ciblak MA, et al. First-year results of the Global Influenza Hospital Surveillance Network: 2012-2013 Northern hemisphere influenza season. BMC Public Health 2014; 14: 564.

30. Ortiz JR, Neuzil KM, Shay DK, Rue TC, Neradilek MB, Zhou H, et al. The burden of influenza-associated critical illness hospitalizations. Crit Care Med 2014; 42(11): 2325-32.

31. Tanriover MD, Bagci Bosi T, Ozisik L, Bilgin E, Güzel Tunçcan Ö, Özgen Ö, et al. Poor outcomes among elderly patients hospitalized for influenza-like illness. Curr Med Res Opin 2018; 34(7): 1201-7.

32. Merckx J, Wali R, Schiller I, Caya C, Gore GC, Chartrand C, et al. Diagnostic Accuracy of novel and traditional rapid tests for influenza infection compared with reverse transcriptase polymerase chain reaction: a systematic review and meta-analysis. Ann Intern Med 2017; 167(6): 394- 409.
Tüberküloz ve Toraks-Cover
  • ISSN: 0494-1373
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1951
  • Yayıncı: Tuba Yıldırım
Sayıdaki Diğer Makaleler

Trakeostomili bir hastada COVID-19 enfeksiyonunun başarılı tedavisi

Neriman Defne ALTINTAŞ, Aslıhan GÜRÜN KAYA, Aydın ÇİLEDAĞ, Akın KAYA, Miraç ÖZ, Serhat EROL, Fatma ÇİFTÇİ, Çağlar UZUN, Leyla TALAN, Övgü VELİOĞLU YAKUT, Ezgi GÜLTEN, Zeynep Ceren KARAHAN

Lenfoepitelyoma benzeri akciğer karsinomu: olgu sunumu ve literatürün incelenmesi

Yurdanur ERDOĞAN, Hatice Esra ÖZAYDIN, Funda İNCEKARA, Ali FIRINCIOĞULLARI, Berna AKINCI ÖZYÜREK, Emre YILMAZ

D-dimer seviyeleri ve COVID-19 şiddeti: Sistematik Derleme ve Metaanaliz

Aydın BALCI, Muhammed Emin DÜZ, Elif MENEKŞE

Tuberk Toraks 2020;68(4):419-429Türktaş H, Oğuzülgen İK.419COVID-19 sonrası akciğer sekelleri: uzun dönem takip ve tedavi

Haluk TÜRKTAŞ, İ.Kıvılcım OĞUZÜLGEN

Fatal contralateral pneumothorax in a patient with pneumonectomy

Katsunori KAGOHASHI, Hiroaki SATOH

Sliding trakeoplasti ile tedavi edilen nadir bir olgu: h-tipi trakeoözefageal fistül

Ulaş KUMBASAR, Rıza Önder GÜNAYDIN, Serkan UYSAL, Rıza DOĞAN

Fiberoptik bronkoskopi sırasında transkütanöz karbondioksit ve saturasyon monitorizasyonunun değerlendirilmesi

Hikmet FIRAT, Merve YUMRUKUZ ŞENEL, Emine Bahar KURT

Evaluation of transcutaneous carbon dioxide and saturation monitoring during fiberoptic bronchoscopy

Merve Yumrukuz ŞENEL, Hikmet FIRAT, Emine Bahar KURT

Treatment approach to apnestic breathing in Arnold Chiari malformation: any role of non-invasive ventilation?

Antonio ESQUINAS, Mediha TÜRKTAN

The rising star ‘tele-pulmonary rehabilitation’ in pandemic times: the first application from Turkey

İpek CANDEMİR, Pınar ERGÜN