Adenoviral Respiratory Infection-Associated Mortality in Children: A Retrospective Case Series.

Autor:	Spaeder MC; Division of Pediatric Critical Care, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia, United States., Stewart C; Division of Critical Care Medicine, Nationwide Children's Hospital, Columbus, Ohio, United States., Sharron MP; Division of Critical Care Medicine, Children's National Hospital, Washington, District of Columbia, United States., Noether JR; Division of Pediatric Critical Care, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, United States., Martinez-Schlurman N; Division of Pediatric Critical Care, University of Florida School of Medicine, Gainesville, Florida, United States., Kavanagh RP; Division of Pediatric Critical Care, Pennsylvania State University School of Medicine, Hershey, Pennsylvania, United States., Signoff JK; Division of Pediatric Critical Care, University of California at Davis School of Medicine, Sacramento, California, United States., McCrory MC; Pediatric Critical Care, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States., Eidman DB; Pediatric Critical Care, Yale University School of Medicine, New Haven, Connecticut, United States., Subbaswamy AV; Division of Pediatric Critical Care, University of New Mexico School of Medicine, Albuquerque, New Mexico, United States., Shea PL; Division of Pediatric Critical Care, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States., Harwayne-Gidansky I; Division of Pediatric Critical Care, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, United States., Ninmer EK; Division of Pediatric Critical Care, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia, United States., Sheram ML; Department of Pediatrics, Medical College of Georgia at Augusta University, Augusta, Georgia, United States., Watson CM; Department of Pediatrics, Medical College of Georgia at Augusta University, Augusta, Georgia, United States.
Jazyk:	angličtina
Zdroj:	Journal of pediatric intensive care [J Pediatr Intensive Care] 2020 Oct 26; Vol. 11 (1), pp. 13-18. Date of Electronic Publication: 2020 Oct 26 (Print Publication: 2022).
DOI:	10.1055/s-0040-1718868
Abstrakt:	Viral respiratory infections are a leading cause of illness and hospitalization in young children worldwide. Case fatality rates in pediatric patients with adenoviral lower respiratory tract infection requiring intensive care unit (ICU) admission have been reported between 7 and 22%. We investigated the demographics and clinical characteristics in pediatric mortalities associated with adenoviral respiratory infection at 12 academic children's hospitals in the United States. There were 107 mortality cases included in our study, 73% of which had a chronic medical condition. The most common chronic medical condition was immunocompromised state in 37 cases (35%). The incidences of pediatric acute respiratory distress syndrome (78%) and multiple organ dysfunction syndrome (94%) were profound. Immunocompetent cases were more likely to receive mechanical ventilation within the first hour of ICU admission (60 vs. 14%, p  < 0.001) and extracorporeal membrane oxygenation (27 vs. 5%, p  = 0.009), and less likely to receive continuous renal replacement therapy (20 vs. 49%, p  = 0.002) or have renal dysfunction (54 vs. 78%, p  = 0.014) as compared with immunocompromised cases. Immunocompromised cases were more likely to have bacteremia (57 vs. 16%, p  < 0.001) and adenoviremia (51 vs. 17%, p  < 0.001) and be treated with antiviral medications (81 vs. 26%, p  < 0.001). We observed a high burden of nonrespiratory organ system dysfunction in a cohort of pediatric case fatalities with adenoviral respiratory infection. The majority of cases had a chronic medical condition associated with an increased risk of complications from viral respiratory illness, most notably immunocompromised state. Important treatment differences were noted between immunocompromised and immunocompetent cases. Competing Interests: Conflict of Interest None declared. (Thieme. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu