Prognostic Factors of Severe Viral Pneumonia Induced Moderate to Severe Acute Respiratory Distress Syndrome_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

LuShanhong , LiJunhui , OuyangSha , TanHongyi ,  PanPinhua

Department of Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China;

Corresponding author：

PanPinhua, Email: pinhuapan668@126.com

Keywords：

Viral pneumonia; Acute respiratory distress syndrome; Prognosis

DOI：

10.7507/1671-6205.2014137

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the clinical characteristics and prognostic factors of severe viral pneumonia induced moderate to severe acute respiratory distress syndrome (ARDS). Methods Twenty patients with severe viral pneumonia induced moderate to severe ARDS admitted in the Respiratory Intensive Care Unit(RICU) in Xiangya Hospital of Central South University from January 2011 to April 2014 were included in the study.The clinical characteristics and prognostic factors were analyzed retrospectively by analysis of variance(ANOVA). Results Five patients developed secondary bacterial infections,while three patients developed secondary fungal infections,among which 2 patients developed both bacterial and fungal infections.Fourteen patients died during hospitalization. ANOVA revealed that gender,body temperature,respiratory frequency,pulse frequency,white blood cell count (WBC),hemoglobin(Hb),platelet(Plt),prothrombin time (PT),albumin(Alb),blood urea nitrogen(BUN),serum creatinine(Scr),total bilirubin(TBIL),serum sodium,serum potassium,erythrocyte sedimentation rate (ESR),C-reactive protein(CRP),procalcitionin(PCT),pH,PaCO₂,PaO₂ and FiO₂ were not significantly different between the dead patients and the alive patients (P>0.05).Whereas the age,length of hospital stay,duration of mechanical ventilation,oxygenation index,and the severity of ARDS were significantly different between the dead patients and the alive patients (P<0.05). Conclusion Age,oxygenation index and severity of ARDS can influence the prognosis of patients with severe viral pneumonia induced moderate to severe ARDS.

Citation： LuShanhong, LiJunhui, OuyangSha, TanHongyi, PanPinhua. Prognostic Factors of Severe Viral Pneumonia Induced Moderate to Severe Acute Respiratory Distress Syndrome. Chinese Journal of Respiratory and Critical Care Medicine, 2014, 13(6): 560-564. doi: 10.7507/1671-6205.2014137 Copy

1.	Mikkelsen ME,Shah CV,Meyer NJ,et al.The epidemiology of acute respiratory distress syndrome in patients presenting to the emergency department with severe sepsis.Shock,2013,40:375-381.
2.	Wheeler AP,Bernard GR.Acute lung injury and the acute respiratory distress syndrome:a clinical review.Lancet,2007,369:1553-1564.
3.	Bauer TT,Ewig S,Rodloff AC,et al.Acute respiratory distress syndrome and pneumonia:a comprehensive review of clinical data.Clin Infect Dis,2006,43:748-756.
4.	Ferguson ND,Fan E,Camporota L,et al.The Berlin definition of ARDS:an expanded rationale,justification,and supplementary material.Intensive Care Med,2012,38:1573-1582.
5.	Mandell LA,Wunderink RG,Anzueto A,et al.Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults.Clin Infect Dis,2007,44 Suppl 2:S27-S72.
6.	Ruuskanen O,Lahti E,Jennings LC,et al.Viral pneumonia.Lancet,2011,377:1264-1275.
7.	Huijskens EG,Koopmans M,Palmen FM,et al.The value of signs and symptoms in differentiating between bacterial,viral and mixed aetiology in patients with community-acquired pneumonia.J Med Microbiol,2014,63:441-452.
8.	Eccles R.Understanding the symptoms of the common cold and influenza.Lancet Infect Dis,2005,5:718-725.
9.	Franquet T.Imaging of pulmonary viral pneumonia.Radiology,2011,260:18-39.
10.	Guo W,Wang J,Sheng M,et al.Radiological findings in 210 paediatric patients with viral pneumonia:a retrospective case study.Br J Radiol,2012,85:1385-1389.
11.	Hong HL,Hong SB,Ko GB,et al.Viral infection is not uncommon in adult patients with severe hospital-acquired pneumonia.PLoS One,2014,9:e95865.
12.	Díaz A,Barria P,Niederman M,et al.Etiology of community-acquired pneumonia in hospitalized patients in Chile:the increasing prevalence of respiratory viruses among classic pathogens.Chest,2007,131:779-787.
13.	Jennings LC,Anderson TP,Beynon KA,et al.Incidence and characteristics of viral community-acquired pneumonia in adults.Thorax,2008,63:42-48.
14.	Falsey AR,Walsh EE.Viral pneumonia in older adults.Clin Infect Dis,2006,42:518-524.
15.	Britos M,Smoot E,Liu KD,et al.The value of positive end-expiratory pressure and FiO₂ criteria in the definition of the acute respiratory distress syndrome.Crit Care Med,2011,39:2025-2030.
16.	Ahn S,Kim WY,Kim SH,et al.Role of procalcitonin and C-reactive protein in differentiation of mixed bacterial infection from 2009 H1N1 viral pneumonia.Influenza Other Respir Viruses,2011,5:398-403.
17.	McCullers JA.Insights into the interaction between influenza virus and pneumococcus.Clin Microbiol Rev,2006,19:571-582.
18.	Yoo JK,Kim TS,Hufford MM,et al.Viral infection of the lung:host response and sequelae.J Allergy Clin Immunol,2013,132:1263-1276;quiz 1277.
19.	Writing Committee of the WHO Consultation on Clinical Aspects of Pandemic (H1N1) 2009 Influenza,Bautista E,Chotpitayasunondh T,et al.Clinical aspects of pandemic 2009 influenza A (H1N1) virus infection.N Engl J Med,2010,362:1708-1719.
20.	Juven T,Mertsola J,Waris M,et al.Clinical response to antibiotic therapy for community-acquired pneumonia.Eur J Pediatr,2004,163:140-144.
21.	Morens DM,Taubenberger JK,Fauci AS.Predominant role of bacterial pneumonia as a cause of death in pandemic influenza:implications for pandemic influenza preparedness.J Infect Dis,2008,198:962-970.
22.	Johansson N,Kalin M,Hedlund J.Clinical impact of combined viral and bacterial infection in patients with community-acquired pneumonia.Scand J Infect Dis,2011,43:609-615.
23.	Mirsaeidi M,Peyrani P,Aliberti S,et al.Thrombocytopenia and thrombocytosis at time of hospitalization predict mortality in patients with community-acquired pneumonia.Chest,2010,137:416-420.
24.	Brogly N,Devos P,Boussekey N,et al.Impact of thrombocytopenia on outcome of patients admitted to ICU for severe community-acquired pneumonia.J Infect,2007,55:136-140.

1. Mikkelsen ME,Shah CV,Meyer NJ,et al.The epidemiology of acute respiratory distress syndrome in patients presenting to the emergency department with severe sepsis.Shock,2013,40:375-381.
2. Wheeler AP,Bernard GR.Acute lung injury and the acute respiratory distress syndrome:a clinical review.Lancet,2007,369:1553-1564.
3. Bauer TT,Ewig S,Rodloff AC,et al.Acute respiratory distress syndrome and pneumonia:a comprehensive review of clinical data.Clin Infect Dis,2006,43:748-756.
4. Ferguson ND,Fan E,Camporota L,et al.The Berlin definition of ARDS:an expanded rationale,justification,and supplementary material.Intensive Care Med,2012,38:1573-1582.
5. Mandell LA,Wunderink RG,Anzueto A,et al.Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults.Clin Infect Dis,2007,44 Suppl 2:S27-S72.
6. Ruuskanen O,Lahti E,Jennings LC,et al.Viral pneumonia.Lancet,2011,377:1264-1275.
7. Huijskens EG,Koopmans M,Palmen FM,et al.The value of signs and symptoms in differentiating between bacterial,viral and mixed aetiology in patients with community-acquired pneumonia.J Med Microbiol,2014,63:441-452.
8. Eccles R.Understanding the symptoms of the common cold and influenza.Lancet Infect Dis,2005,5:718-725.
9. Franquet T.Imaging of pulmonary viral pneumonia.Radiology,2011,260:18-39.
10. Guo W,Wang J,Sheng M,et al.Radiological findings in 210 paediatric patients with viral pneumonia:a retrospective case study.Br J Radiol,2012,85:1385-1389.
11. Hong HL,Hong SB,Ko GB,et al.Viral infection is not uncommon in adult patients with severe hospital-acquired pneumonia.PLoS One,2014,9:e95865.
12. Díaz A,Barria P,Niederman M,et al.Etiology of community-acquired pneumonia in hospitalized patients in Chile:the increasing prevalence of respiratory viruses among classic pathogens.Chest,2007,131:779-787.
13. Jennings LC,Anderson TP,Beynon KA,et al.Incidence and characteristics of viral community-acquired pneumonia in adults.Thorax,2008,63:42-48.
14. Falsey AR,Walsh EE.Viral pneumonia in older adults.Clin Infect Dis,2006,42:518-524.
15. Britos M,Smoot E,Liu KD,et al.The value of positive end-expiratory pressure and FiO₂ criteria in the definition of the acute respiratory distress syndrome.Crit Care Med,2011,39:2025-2030.
16. Ahn S,Kim WY,Kim SH,et al.Role of procalcitonin and C-reactive protein in differentiation of mixed bacterial infection from 2009 H1N1 viral pneumonia.Influenza Other Respir Viruses,2011,5:398-403.
17. McCullers JA.Insights into the interaction between influenza virus and pneumococcus.Clin Microbiol Rev,2006,19:571-582.
18. Yoo JK,Kim TS,Hufford MM,et al.Viral infection of the lung:host response and sequelae.J Allergy Clin Immunol,2013,132:1263-1276;quiz 1277.
19. Writing Committee of the WHO Consultation on Clinical Aspects of Pandemic (H1N1) 2009 Influenza,Bautista E,Chotpitayasunondh T,et al.Clinical aspects of pandemic 2009 influenza A (H1N1) virus infection.N Engl J Med,2010,362:1708-1719.
20. Juven T,Mertsola J,Waris M,et al.Clinical response to antibiotic therapy for community-acquired pneumonia.Eur J Pediatr,2004,163:140-144.
21. Morens DM,Taubenberger JK,Fauci AS.Predominant role of bacterial pneumonia as a cause of death in pandemic influenza:implications for pandemic influenza preparedness.J Infect Dis,2008,198:962-970.
22. Johansson N,Kalin M,Hedlund J.Clinical impact of combined viral and bacterial infection in patients with community-acquired pneumonia.Scand J Infect Dis,2011,43:609-615.
23. Mirsaeidi M,Peyrani P,Aliberti S,et al.Thrombocytopenia and thrombocytosis at time of hospitalization predict mortality in patients with community-acquired pneumonia.Chest,2010,137:416-420.
24. Brogly N,Devos P,Boussekey N,et al.Impact of thrombocytopenia on outcome of patients admitted to ICU for severe community-acquired pneumonia.J Infect,2007,55:136-140.

Chinese Journal of Respiratory and Critical Care Medicine

Prognostic Factors of Severe Viral Pneumonia Induced Moderate to Severe Acute Respiratory Distress Syndrome

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content