Clinical characteristics of influenza acute respiratory distress syndrome in 2017 to 2018
- Author:
- No author available
- Journal Title:
- Chinese Journal of Tuberculosis and Respiratory Diseases
- Issue:
- 1
- DOI:
- 10.3760/cma.j.issn.1001-0939.2019.01.005
- Key Word:
- 流感,人;肺炎;呼吸窘迫综合征,成人;Influenza,human;Pneumonia;Respiratory distress syndrome,adult
Abstract： Objective To describe the clinical characteristics of acute respiratory distress syndrome (ARDS) caused by severe influenza virus in our hospital.Method From November 2017 to February 2018,48 patients were diagnosed with ARDS caused by influenza virus pneumonia.There characteristics,treatment,and outcomes were summarized and analyzed.According to the prognosis,the patients were divided into a survival group and a death group for comparative analysis.The muhivariable logistic regression analysis was used for risk factors of hospital mortality.Result Thirty-one patients were confirmed to have influenza A virus infection,3 influenza B virus,2 mixed infection,while 12 patients were diagnosed by clinical criteria.Eighteen patients died,with a mortality of 38％.Twenty-six patients (54％) were co-infected by other pathogenic microorganisms,including 17 cases of invasive aspergillus infection.Sixteen patients (33％) acquired nosocomial infection that significantly correlated with the hospital mortality,P=0.003.Multivariable logistic regression analysis showed that higher age (OR=1.086,95％ CI:1.016-1.016),P=0.015),longer duration of flu-like symptoms to RICU time (OR=1.196,95％ CI:1.031-1.031,P=0.018) and lower PaO2 / FiO2 (OR=0.973,95％ CI:0.951-0.951,P=0.O17) were independent risk factors for hospital mortality.Conclusion In the flu season of 2017-2018,the patients of ARDS caused by severe influenza pneumonia were mainly influenza A virus,with a mortality of 38％.Co-infection was very common,especially aspergillus infection.Nosocomial infection was common and significantly correlated with high mortality.Lower PaO2/FiO2,higher age and the longer duration from influenza-like symptoms to RICU was independent risk factors for high hospital mortality.
- [1]卫生部流行性感冒诊断与治疗指南编撰专家组.流行性感冒诊断与治疗指南（2011年版）[J].2011,(10).
- [2]中华医学会呼吸病学分会.中国成人社区获得性肺炎诊断和治疗指南（2016年版）[J].2016,(4).
- [3]张立成,张锦前,郭利民,等.重症甲型H1N1流感并发急性呼吸窘迫综合征的临床特点及危险因素分析[J].2014,(3).
- [4]Combes, A.,Hajage, D.,Capellier, G.,etc.Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome[J].2018,378(21).
- [5]Pinto R,Kumar A,Zarychanski R.Critically ill patients with 2009 influenza A(H1N1) infection in Canada.[J].2009,302(17).
- [6]Jain S,Kamimoto L,Bramley AM.Hospitalized patients with 2009 H1N1 influenza in the United States, April-June 2009.[J].2009,361(20).
- [7]Peek,Mr,Hibbert,C.L.,Cooper,N.,etc.Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial[J].2009,374(9698).
- [8]J J, Fischer,D H, Walker.Invasive pulmonary aspergillosis associated with influenza.[J].1979,241(14).
- [9]Zhou, Fei,Li, Hui,Gu, Li,etc.Risk factors for nosocomial infection among hospitalised severe influenza A(H1N1)pdm09 patients[J].2018,134.
- [10]Thompson,B.T.,Caldwell,E.,Slutsky,A.S.,etc.Acute respiratory distress syndrome: The Berlin definition[J].2012,307(23).
- [11]Schauwvlieghe, Alexander F. A. D.,Rijnders, Bart J. A.,Philips, Nele,etc.Invasive aspergillosis in patients admitted to the intensive care unit with severe influenza: a retrospective cohort study[J].2018,6(10).
- [12]Rozencwajg, Sacha,Br��chot, Nicolas,Schmidt, Matthieu,etc.Co-infection with influenza-associated acute respiratory distress syndrome requiring extracorporeal membrane oxygenation.[J].2018,51(3).
- [13]Kalil, Andre C.,Metersky, Mark L.,Klompas, Michael,etc.Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society[J].2016,63(5).
- [14]Singer, Mervyn,Deutschman, Clifford S.,Seymour, Christopher Warren,etc.The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)[J].2016,315(8).
- [15]Jorens,P.,Baar,I.,Wilmer,A.,etc.Invasive pulmonary aspergillosis is a frequent complication of critically ill H1N1 patients: A retrospective study[J].2012,38(11).
- [16]Estenssoro,E.,Ríos,F.G.,Apezteguía,C.,etc.Pandemic 2009 influenza A in Argentina: A study of 337 patients on mechanical ventilation[J].2010,182(1).
- [17]Felton, T. W.,Richardson, M. D.,Muldoon, E. G.,etc.Invasive pulmonary aspergillosis is associated with adverse clinical outcomes in critically ill patients receiving veno-venous extracorporeal membrane oxygenation[J].2018,37(7).
- [18]Haas, Pieter-Jan,Hodiamont, Caspar J.,dos Santos, Claudy Oliveira,etc.Influenza-associated Aspergillosis in Critically III Patients[J].2017,196(4).
- [19]Kim,S.H.,Kim,S.C.,Lee,M.G.,etc.Epidemiological analysis of critically ill adult patients with pandemic influenza A(H1N1) in South Korea[J].2013,141(5).
- [20]Dominguez-Cherit, Guillermo,De la Torre, Alethse,Rishu, Asgar,etc.Influenza A (H1N1pdm09)-Related Critical Illness and Mortality in Mexico and Canada, 2014[J].2016,44(10).
- [21]Patterson, Thomas F.,Thompson, George R., III,Denning, David W.,etc.Practice Guidelines for the Diagnosis and Management of Aspergillosis: 2016 Update by the Infectious Diseases Society of America[J].2016,63(4).
- [22]Jones D,Bailey M,Davies A.Extracorporeal Membrane Oxygenation for 2009 Influenza A(H1N1) Acute Respiratory Distress Syndrome.[J].2009,302(17).
- [23]Gori, Andrea,Scaravilli, Vittorio,Di Bella, Stefano,etc.Nosocomial Infections During Extracorporeal Membrane Oxygenation: Incidence, Etiology, and Impact on Patients' Outcome[J].2017,45(10).