Critical care management of adults with community-acquired severe respiratory viral infection.
Identifieur interne : 000797 ( PubMed/Checkpoint ); précédent : 000796; suivant : 000798Critical care management of adults with community-acquired severe respiratory viral infection.
Auteurs : Yaseen M. Arabi [Arabie saoudite] ; Robert Fowler [Canada] ; Frederick G. Hayden [États-Unis]Source :
- Intensive care medicine [ 1432-1238 ] ; 2020.
Descripteurs français
- KwdFr :
- Adulte, Antiviraux (usage thérapeutique), Grippe humaine (), Humains, Indice de gravité médicale, Infections communautaires (), Infections à coronavirus (), Macrolides (usage thérapeutique), Maladie grave, Médecine factuelle, Oséltamivir (usage thérapeutique), Pneumopathie infectieuse, Pneumopathie virale (), Soins de réanimation (normes), Syndrome respiratoire aigu sévère (), Unités de soins intensifs, Ventilation artificielle, Ventilation non effractive.
- MESH :
- normes : Soins de réanimation.
- usage thérapeutique : Antiviraux, Macrolides, Oséltamivir.
- Adulte, Grippe humaine, Humains, Indice de gravité médicale, Infections communautaires, Infections à coronavirus, Maladie grave, Médecine factuelle, Pneumopathie infectieuse, Pneumopathie virale, Syndrome respiratoire aigu sévère, Unités de soins intensifs, Ventilation artificielle, Ventilation non effractive.
English descriptors
- KwdEn :
- Adult, Antiviral Agents (therapeutic use), Community-Acquired Infections (therapy), Coronavirus Infections (therapy), Critical Care (standards), Critical Illness, Evidence-Based Medicine, Humans, Influenza, Human (therapy), Intensive Care Units, Macrolides (therapeutic use), Noninvasive Ventilation, Oseltamivir (therapeutic use), Pneumonia, Pneumonia, Viral (therapy), Respiration, Artificial, Severe Acute Respiratory Syndrome (therapy), Severity of Illness Index.
- MESH :
- chemical , therapeutic use : Antiviral Agents, Macrolides, Oseltamivir.
- standards : Critical Care.
- therapy : Community-Acquired Infections, Coronavirus Infections, Influenza, Human, Pneumonia, Viral, Severe Acute Respiratory Syndrome.
- Adult, Critical Illness, Evidence-Based Medicine, Humans, Intensive Care Units, Noninvasive Ventilation, Pneumonia, Respiration, Artificial, Severity of Illness Index.
Abstract
With the expanding use of molecular assays, viral pathogens are increasingly recognized among critically ill adult patients with community-acquired severe respiratory illness; studies have detected respiratory viral infections (RVIs) in 17-53% of such patients. In addition, novel pathogens including zoonotic coronaviruses like the agents causing Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS) and the 2019 novel coronavirus (2019 nCoV) are still being identified. Patients with severe RVIs requiring ICU care present typically with hypoxemic respiratory failure. Oseltamivir is the most widely used neuraminidase inhibitor for treatment of influenza; data suggest that early use is associated with reduced mortality in critically ill patients with influenza. At present, there are no antiviral therapies of proven efficacy for other severe RVIs. Several adjunctive pharmacologic interventions have been studied for their immunomodulatory effects, including macrolides, corticosteroids, cyclooxygenase-2 inhibitors, sirolimus, statins, anti-influenza immune plasma, and vitamin C, but none is recommended at present in severe RVIs. Evidence-based supportive care is the mainstay for management of severe respiratory viral infection. Non-invasive ventilation in patients with severe RVI causing acute hypoxemic respiratory failure and pneumonia is associated with a high likelihood of transition to invasive ventilation. Limited existing knowledge highlights the need for data regarding supportive care and adjunctive pharmacologic therapy that is specific for critically ill patients with severe RVI. There is a need for more pragmatic and efficient designs to test different therapeutics both individually and in combination.
DOI: 10.1007/s00134-020-05943-5
PubMed: 32040667
Affiliations:
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In addition, novel pathogens including zoonotic coronaviruses like the agents causing Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS) and the 2019 novel coronavirus (2019 nCoV) are still being identified. Patients with severe RVIs requiring ICU care present typically with hypoxemic respiratory failure. Oseltamivir is the most widely used neuraminidase inhibitor for treatment of influenza; data suggest that early use is associated with reduced mortality in critically ill patients with influenza. At present, there are no antiviral therapies of proven efficacy for other severe RVIs. Several adjunctive pharmacologic interventions have been studied for their immunomodulatory effects, including macrolides, corticosteroids, cyclooxygenase-2 inhibitors, sirolimus, statins, anti-influenza immune plasma, and vitamin C, but none is recommended at present in severe RVIs. Evidence-based supportive care is the mainstay for management of severe respiratory viral infection. Non-invasive ventilation in patients with severe RVI causing acute hypoxemic respiratory failure and pneumonia is associated with a high likelihood of transition to invasive ventilation. Limited existing knowledge highlights the need for data regarding supportive care and adjunctive pharmacologic therapy that is specific for critically ill patients with severe RVI. There is a need for more pragmatic and efficient designs to test different therapeutics both individually and in combination.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32040667</PMID><DateCompleted><Year>2020</Year><Month>03</Month><Day>18</Day></DateCompleted><DateRevised><Year>2020</Year><Month>03</Month><Day>25</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1432-1238</ISSN><JournalIssue CitedMedium="Internet"><Volume>46</Volume><Issue>2</Issue><PubDate><Year>2020</Year><Month>02</Month></PubDate></JournalIssue><Title>Intensive care medicine</Title><ISOAbbreviation>Intensive Care Med</ISOAbbreviation></Journal><ArticleTitle>Critical care management of adults with community-acquired severe respiratory viral infection.</ArticleTitle><Pagination><MedlinePgn>315-328</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1007/s00134-020-05943-5</ELocationID><Abstract><AbstractText>With the expanding use of molecular assays, viral pathogens are increasingly recognized among critically ill adult patients with community-acquired severe respiratory illness; studies have detected respiratory viral infections (RVIs) in 17-53% of such patients. In addition, novel pathogens including zoonotic coronaviruses like the agents causing Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS) and the 2019 novel coronavirus (2019 nCoV) are still being identified. Patients with severe RVIs requiring ICU care present typically with hypoxemic respiratory failure. Oseltamivir is the most widely used neuraminidase inhibitor for treatment of influenza; data suggest that early use is associated with reduced mortality in critically ill patients with influenza. At present, there are no antiviral therapies of proven efficacy for other severe RVIs. Several adjunctive pharmacologic interventions have been studied for their immunomodulatory effects, including macrolides, corticosteroids, cyclooxygenase-2 inhibitors, sirolimus, statins, anti-influenza immune plasma, and vitamin C, but none is recommended at present in severe RVIs. Evidence-based supportive care is the mainstay for management of severe respiratory viral infection. Non-invasive ventilation in patients with severe RVI causing acute hypoxemic respiratory failure and pneumonia is associated with a high likelihood of transition to invasive ventilation. Limited existing knowledge highlights the need for data regarding supportive care and adjunctive pharmacologic therapy that is specific for critically ill patients with severe RVI. There is a need for more pragmatic and efficient designs to test different therapeutics both individually and in combination.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Arabi</LastName><ForeName>Yaseen M</ForeName><Initials>YM</Initials><Identifier Source="ORCID">0000-0001-5735-6241</Identifier><AffiliationInfo><Affiliation>College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. Arabi@ngha.med.sa.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. Arabi@ngha.med.sa.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Intensive Care Department, King Abdulaziz Medical City, P.O. Box 22490, Riyadh, 11426, Saudi Arabia. Arabi@ngha.med.sa.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fowler</LastName><ForeName>Robert</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Critical Care Medicine, Sunnybrook Hospital, Toronto, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Medicine, Sunnybrook Hospital, Toronto, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hayden</LastName><ForeName>Frederick G</ForeName><Initials>FG</Initials><AffiliationInfo><Affiliation>Department of Medicine, Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA, USA.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal 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MajorTopicYN="N">Pneumonia</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012121" MajorTopicYN="Y">Respiration, Artificial</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D045169" MajorTopicYN="N">Severe Acute Respiratory Syndrome</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012720" MajorTopicYN="N">Severity of Illness Index</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">Acute respiratory distress syndrome</Keyword><Keyword MajorTopicYN="Y">Antiviral therapy</Keyword><Keyword MajorTopicYN="Y">Coronavirus</Keyword><Keyword MajorTopicYN="Y">Influenza</Keyword><Keyword MajorTopicYN="Y">Neuraminidase 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