Infectious Disease

Viral co-detection in connection with longer ventilation times in critically ill infants

March 25, 2021

2 min read

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Disclosure:
Shutes does not report any relevant financial information. In the study you will find all relevant financial information from all other authors.

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Identifying the virus type and number can be useful in predicting the duration of positive pressure ventilation in critically ill infants with bronchiolitis, according to results published in the Annals of the American Thoracic Society.

“In critically ill infants, these results provide predictive value to facilitate the prognosis for parents, improve the staffing of guides, and provide a benchmark for identifying infants whose severity is outside the norm,” said Brittany L. Shutes, MD, Pediatrician in The Department of Pediatrics in the Department of Pediatric Intensive Care Medicine at Nationwide Children’s Hospital and Ohio State University College of Medicine and colleagues wrote.

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The researchers conducted a 3-year retrospective cohort study examining 984 infants in a quaternary pediatric intensive care unit from February 2014 to February 2017. The patients received positive pressure ventilation (PPV) because of a suspected respiratory infection, but without significant congenital heart disease, care restrictions and basic PPV use or tracheotomy.

The researchers identified respiratory viruses and analyzed the PPV duration according to the viral etiology.

In the cohort, 64% of the infants had a single virus, 23% of the infants had two viruses, 4% had three viruses, and 9% had no viruses. The viruses detected most frequently were the respiratory syncytial virus (42%) and the rhinovirus / enterovirus (15%).

Infants with more than two viruses detected had a longer PPV duration than infants with one or no virus (RR = 1.4; 95% CI, 1.2-1.6; P <0.001). Detection of rhinovirus / enterovirus compared to respiratory syncytial virus alone and other virus combinations was associated with shorter duration of PPV (RR = 0.7; 95% CI, 0.62-0.87; P <0.001) and non-invasive PPV (RR = 0.7) associated 95% CI, 0.6-0.85; P <0.001) and invasive PPV (RR = 0.7; 95% CI, 0.54-0.83; P <0.001) after adjustment for weight, prematurity and early administration of antibiotic therapy, rhinovirus / enterovirus identification.

According to the researchers, the results of this study provide important insight and predictive value for critically ill infants, despite the cost of systematic respiratory virus testing.

“Although systematic respiratory virus tests can be costly for critically ill infants, these results provide some important insight and predictive value. What is important is that the ongoing improvements in this technology make these results available to the bedside doctor within hours, ”the researchers wrote.

Looking ahead, Shutes and colleagues said these data “suggest that future randomized controlled trials of drugs and other therapies in critically ill infants with respiratory infections should be stratified by virus type.”

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