儿科重症监护中的呼吸道合胞病毒感染:社会人口学数据和临床结果与病毒和细菌合并感染的关联。

IF 1.3 Q3 PEDIATRICS Turkish archives of pediatrics Pub Date : 2024-09-02 DOI:10.5152/TurkArchPediatr.2024.24149
Ülkem Koçoğlu Barlas, Nihal Akçay, Leyla Telhan, Murat Kanğın, Özge Umur, Agop Çıtak, Hazal Ceren Tuğrul, Seher Erdoğan, Mehmet Emin Menentoğlu, Esra Şevketoğlu, Muhterem Duyu, Kübra Boydağ Güvenç, Yaşar Yusuf Can, Batuhan Türkoğlu
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引用次数: 0

摘要

该研究旨在评估儿科重症监护室(PICU)中随访病例的呼吸道合胞病毒(RSV)感染情况。研究设计为前瞻性队列,在 6 个 PICU 中进行。共分为三组:仅 RSV (+)、RSV (v+) 和 RSV (b+) 两组,前者除 RSV 外,其他病毒病原体也呈阳性;后者除 RSV 外,细菌病原体也呈阳性。研究共纳入 119 例病例,其中 67 例(56.3%)为男性。与其他组别相比,RSV(+)组的 pH 值较低,与 RSV(v+)组相比,RSV(v+)组的急性支气管炎/支气管炎诊断率较高。与 RSV(+)组相比,RSV(v+)组的碳酸氢盐水平更高、肌酐水平更高、住院时间更长、儿科死亡率风险-3 评分(PRISM-3)更高。与其他组别相比,RSV(b+)组病例更年轻,体重也更轻。此外,RSV(b+)组的 C 反应蛋白和降钙素原(PCT)水平较高,使用高流量鼻导管-氧气疗法(HFNC-OT)的比例也较高。多元线性回归分析表明,PRISM-3 评分、PCT 水平、小儿急性呼吸窘迫综合征诊断、吸入类固醇的使用、慢性病状态和入院时的心率与 PICU 的住院时间有关。在 RSV 感染中,高流量鼻导管供氧疗法仍然是最常用的呼吸支持方法。伴随 RSV 的病毒感染会加重疾病的严重程度。
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Respiratory Syncytial Virus Infections in Pediatric Intensive Care: Association of Sociodemographic Data and Clinical Outcomes with Viral and Bacterial Co-infections.

The aim of the study was to evaluate respiratory syncytial virus (RSV) infections in cases followed in the pediatric intensive care unit (PICU). The study was designed as a prospective cohort in 6 PICUs. There were 3 groups: only RSV (+), RSV (v+) who were positive for another viral agent(s) in addition to RSV, and RSV (b+) who were positive for a bacterial agent(s) in addition to RSV. A total of 119 cases were included in the study, 67 (56.3%) of whom were male. The RSV (+) group had a lower pH compared to the other groups and a higher rate of acute bronc hiolitis/bronchitis diagnoses compared to the RSV (v+) group. The RSV (v+) group had higher bicarbonate levels, higher creatinine levels, longer hospital stays, and higher Pediatric Risk of Mortality-3 scores (PRISM-3) compared to the RSV (+) group. Cases with RSV (b+) were younger and also had lower body weight compared to the other groups. Furthermore, the RSV (b+) group had higher C-reactive protein and Procalcitonin (PCT) levels and higher rates of High Flow Nasal Cannula-Oxygen Therapy (HFNC-OT) use. Multiple linear regression analysis revealed that PRISM-3 score, PCT levels, Pediatric Acute Respiratory Distress Syndrome diagnoses, inhaled steroid use, chronic illness status, and heart rate on admission were associated with the length of stay in the PICU. High flow nasal cannula-oxygen therapy continues to be the most frequently preferred respiratory support method in RSV infections. Viral infections accompanying RSV can increase the severity of the disease.

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