Critical care management of hantavirus cardiopulmonary syndrome. A narrative review.

Autor: Ulloa-Morrison R; Unidad de Cuidados Intensivos, Hospital Las Higueras, Talcahuano, Chile., Pavez N; Unidad de Cuidados Intensivos, Hospital Guillermo Grant Benavente, Concepción, Chile; Departamento de Medicina Interna, Universidad de Concepción, Concepción, Chile., Parra E; Unidad de Cuidados Intensivos, Hospital Las Higueras, Talcahuano, Chile., Lopez R; Departamento de Paciente Crítico, Clínica Alemana de Santiago, Santiago, Chile; Grupo Intensivo, ICIM, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile., Mondaca R; Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile., Fernandez P; Unidad de Cuidados Intensivos, Hospital Guillermo Grant Benavente, Concepción, Chile; Departamento de Medicina Interna, Universidad de Concepción, Concepción, Chile., Kraunik D; Unidad de Cuidados Intensivos, Hospital Las Higueras, Talcahuano, Chile; Departamento de Medicina Interna, Universidad de Concepción, Concepción, Chile., Sanhueza C; Unidad de Cuidados Intensivos, Hospital Las Higueras, Talcahuano, Chile., Bravo S; Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile., Cornu MG; Unidad de Cuidados Intensivos de CMIC, Neuquén, Argentina., Kattan E; Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. Electronic address: e.kattan@gmail.com.
Jazyk: angličtina
Zdroj: Journal of critical care [J Crit Care] 2024 Dec; Vol. 84, pp. 154867. Date of Electronic Publication: 2024 Jul 17.
DOI: 10.1016/j.jcrc.2024.154867
Abstrakt: Hantaviruses, members of the Bunyaviridae family, can cause two patterns of disease in humans, hantavirus hemorrhagic fever with renal syndrome (HFRS) and cardiopulmonary syndrome (HCPS), being the latter hegemonic on the American continent. Andesvirus is one of the strains that can cause HCPS and is endemic in Chile. Its transmission occurs through direct or indirect contact with infected rodents' urine, saliva, or feces and inhalation of aerosol particles containing the virus. HCPS rapidly evolves into acute but reversible multiorgan dysfunction. The hemodynamic pattern of HCPS is not identical to that of cardiogenic or septic shock, being characterized by hypovolemia, systolic dysfunction, and pulmonary edema secondary to increased permeability. Given the lack of specific effective therapies to treat this viral infection, the focus of treatment lies in the timely provision of intensive care, specifically hemodynamic and respiratory support, which often requires veno-arterial extracorporeal membrane oxygenation (VA-ECMO). This narrative review aims to provide insights into specific ICU management of HCPS based on the available evidence and gathered experience in Chile and South America including perspectives of pathophysiology, organ dysfunction kinetics, timely life support provision, safe patient transportation, and key challenges for the future.
Competing Interests: Declaration of competing interest The authors declare that they have no competing interests.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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