scholarly journals Lower airway sampling greatly increases detection of respiratory viruses in critically ill patients: the COURSE study

Critical Care ◽  
2014 ◽  
Vol 18 (Suppl 1) ◽  
pp. P341 ◽  
Author(s):  
F Van Someren Gréve ◽  
KF Van der Sluijs ◽  
NP Juffermans ◽  
T Winters ◽  
SP Rebers ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Respiratory Viruses ◽  
Lower Airway

scholarly journals Influenza or other respiratory viruses: does it matter as the cause of acute respiratory failure in the critically-ill patients?

2020 ◽  
Vol 68 (4) ◽  
pp. 388-398
Author(s):  
Burçin Halaçlı ◽  
Pervin Hancı ◽  
Ebru Ortaç Ersoy ◽  
Serpil Öcal ◽  
Mine Durusu Tanrıöver ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Respiratory Viruses

The surgical airway in the ICU

2016 ◽  
Author(s):  
Danja S. Groves ◽  
Charles G. Durbin
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Prolonged Mechanical Ventilation ◽  
Upper Airway ◽  
Patient Comfort ◽  
Lower Airway ◽  
Early Tracheostomy ◽  
Surgical Tracheostomy ◽  
Elective Surgical Procedure ◽  
Surgical Airway

Tracheostomy is the most commonly performed (elective) surgical procedure in critically-ill patients. Compared with translaryngeal intubation, tracheostomy improves patient comfort, and leads to shorter length of intensive care unit and hospital stay. It relieves upper airway obstruction, protects the larynx and upper airway from damage, allows access to the lower airway for secretion removal, and provides a stable airway for patients requiring prolonged mechanical ventilation or oxygenation support. Timing of tracheostomy remains controversial and should be individualized; however, early tracheostomy (within 7 days) seems to be beneficial in certain patient populations (head injury, medically critically ill). The evolution of percutaneous techniques are rapidly reducing need for surgical tracheostomy and bedside techniques are safe and efficient, allowing timely tracheostomy with low morbidity. Cricothyrotomy is an emergency surgical airway used to save a life when all attempts at securing a patent airway fail and arrest is eminent. Techniques, timing, risks, benefits, as well as contraindications of the surgical airway in critically-ill patients are discussed in this chapter.

scholarly journals Acute Kidney Injury and Renal Replacement Therapy in COVID-19 Versus Other Respiratory Viruses: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
pp. 205435812110521
Author(s):  
A. Cau ◽  
M. P. Cheng ◽  
Terry Lee ◽  
A. Levin ◽  
T. C. Lee ◽  
...  
Keyword(s):  
Systematic Review ◽  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Severe Acute Respiratory Syndrome ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Respiratory Viruses ◽  
Vasopressor Use

Background: Acute kidney injury (AKI) is a potentially fatal complication of Coronavirus Disease-2019 (COVID-19). Binding of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the virus responsible for COVID-19, to its viral receptor, angiotensin converting enzyme 2 (ACE2), results in viral entry and may cause AKI. Objectives: We performed a systematic review and meta-analysis of the frequencies of AKI and renal replacement therapy (RRT) in critically ill COVID-19 patients and compared those frequencies with patients who were infected by respiratory viruses that bind or downregulate ACE2 (ACE2-associated viruses) and viruses that do not bind nor downregulate ACE2 (non-ACE2-associated viruses). Design: Systematic review and meta-analysis. Setting: Observational studies on COVID-19 and other respiratory viral infections reporting AKI and RRT were included. The exclusion criteria were non-English articles, non-peer-reviewed articles, review articles, studies that included patients under the age of 18, studies including fewer than 10 patients, and studies not reporting AKI and RRT rates. Patients: Adult COVID-19, Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), and influenza patients. Measurements: We extracted the following data from the included studies: author, year, study location, age, sex, race, diabetes mellitus, hypertension, chronic kidney disease, shock, vasopressor use, mortality, intensive care unit (ICU) admission, ICU mortality, AKI, and RRT. Methods: We systematically searched PubMed and EMBASE for articles reporting AKI or RRT. AKI was defined by authors of included studies. Critical illness was defined by ICU admission. We performed a random effects meta-analysis to calculate pooled estimates for the AKI and RRT rate within each virus group using a random intercept logistic regression model. Results: Of 23 655 hospitalized, critically ill COVID-19 patients, AKI frequencies were not significantly different between COVID-19 patients (51%, 95% confidence interval [CI]: 44%-57%) and critically ill patients infected with ACE2-associated (56%, 95% CI: 37%-74%, P = .610) or non-ACE2-associated viruses (63%, 95% CI: 43%-79%, P = .255). Pooled RRT rates were also not significantly different between critically ill, hospitalized patients with COVID-19 (20%, 95% CI: 16%-24%) and ACE2-associated viruses (18%, 95% CI: 8%-33%, P = .747). RRT rates for both COVID-19 and ACE2-associated viruses were significantly different ( P < .001 for both) from non-ACE2-associated viruses (49%, 95% CI: 44%-54%). After adjusting for shock or vasopressor use, AKI and RRT rates were not significantly different between groups. Limitations: Limitations of this study include the heterogeneity of definitions of AKI that were used across different virus studies. We could not match severity of infection or do propensity matching across studies. Most of the included studies were conducted in retrospective fashion. Last, we did not include non-English publications. Conclusions: Our findings suggest that viral ACE2 association does not significantly alter the rates of AKI and RRT among critically ill patients admitted to the ICU. However, the rate of RRT is lower in patients with COVID-19 or ACE2-associated viruses when compared with patients infected with non-ACE2-binding viruses, which might partly be due to the lower frequencies of shock and use of vasopressors in these two virus groups. Prospective studies are necessary to demonstrate whether modulation of the ACE2 axis with Renin-Angiotensin System inhibitors impacts the rates of AKI and whether they are beneficial or harmful in COVID-19 patients.

Influenza and Other Respiratory Viruses Are Underdiagnosed in Critically Ill Patients

2015 ◽  
Vol 43 (4) ◽  
pp. e117 ◽  
Author(s):  
Frank van Someren Gréve ◽  
Marcus J. Schultz ◽  
Menno D. de Jong ◽  
Nicole P. Juffermans
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Respiratory Viruses

Respiratory Viruses in Invasively Ventilated Critically Ill Patients—A Prospective Multicenter Observational Study

2018 ◽  
Vol 46 (1) ◽  
pp. 29-36 ◽  
Author(s):  
Frank van Someren Gréve ◽  
Nicole P. Juffermans ◽  
Lieuwe D. J. Bos ◽  
Jan M. Binnekade ◽  
Annemarije Braber ◽  
...  
Keyword(s):  
Observational Study ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Respiratory Viruses ◽  
Multicenter Observational Study ◽  
Prospective Multicenter Observational Study
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