Cytomegalovirus Seroprevalence as a Risk Factor for Poor Outcome in Acute Respiratory Distress Syndrome*

Abstract The Pediatric Acute Lung Injury Consensus Conference (PALICC) published pediatric-specific guidelines for the definition, management, and research in pediatric acute respiratory distress syndrome (PARDS). Acute viral bronchiolitis (AVB) remains one of the leading causes of admission to PICU. Respiratory syncytial virus (RSV) is the most common cause of AVB. We aimed to evaluate the incidence of PARDS in AVB and identify the risk of RSV as a trigger pathogen for PARDS. This study is a retrospective single-center observational cohort study including children < 2 years of age admitted to the pediatric intensive care unit at St Mary’s Hospital, London, and presented with AVB in 3 years (2016–2018). Clinical and demographic data was collected; PALICC criteria were applied to define PARDS. Data was expressed as median (IQR range); non-parametric tests were used. In this study, 144 infants with acute viral bronchiolitis were admitted to PICU in the study period. Thirty-nine infants fulfilled criteria of PARDS with RSV as the most common virus identified. Bacterial infection was identified as a risk factor for development of PARDS in infants with AVB. Conclusion: AVB is an important cause of PARDS in infants. RSV is associated with a higher risk of PARDS in AVB. Bacterial co-infection is a significant risk factor for development of PARDS in AVB. What is Known:• Bronchiolitis is a common cause of respiratory failure in children under 2 years.• ARDS is a common cause of PICU admission. What is New:• Evaluation of bronchiolitis as a cause of PARDS according to the PALLIC criteria.• Evaluation of different viruses’ outcome in PARDS especially RSV as a commonest cause of AVB.

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Subclinical idiopathic pulmonary fibrosis is also a risk factor of postoperative acute respiratory distress syndrome following thoracic surgery

European Journal of Cardio-Thoracic Surgery ◽

10.1016/j.ejcts.2008.07.028 ◽

2008 ◽

Vol 34 (4) ◽

pp. 878-881 ◽

Cited By ~ 41

Author(s):

Masayuki Chida ◽

Shuichi Ono ◽

Yasushi Hoshikawa ◽

Takashi Kondo

Keyword(s):

Risk Factor ◽

Acute Respiratory Distress Syndrome ◽

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Thoracic Surgery ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome

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Predictive Value of Serum β2‑Microglobulin for Outcomes in Patients with Acute Respiratory Distress Syndrome Caused by Bacterial Infection

10.21203/rs.3.rs-668831/v1 ◽

2021 ◽

Author(s):

Na Cui ◽

Xiaokai Feng ◽

Chunguo Jiang ◽

Jing Wang ◽

Liming Zhang

Keyword(s):

Risk Factor ◽

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Bacterial Infection ◽

Predictive Value ◽

Independent Risk Factor ◽

Distress Syndrome ◽

Survival Group ◽

Β2 Microglobulin

Abstract Background Acute respiratory distress syndrome (ARDS) is a heterogeneous disease with extremely high mortality. We hypothesized that the serum β2-microglobulin (β2MG) level would be elevated and be an independent risk factor for 28-day mortality in patients with ARDS. Methods We retrospectively enrolled 257 patients with ARDS caused by bacterial infection who were admitted consecutively into the Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital from January 1, 2015 to February 28, 2021. Patients were followed for up to 28 days from diagnosis and were divided into a survival group and non-survival group according to their clinical outcomes. The serum β2MG levels and other clinical data were collected. The relationship between serum β2MG levels and 28-day mortality was explored by performing a Cox regression analysis adjusted for age, updated Charlson comorbidity index, disorders of consciousness, septic shock, albumin level, cardiac troponin I level, procalcitonin level, lactic acid level, prothrombin time, and partial pressure of arterial oxygen/fraction of inspired oxygen ratio. Results In this cohort, 161 patients survived, and 96 patients died within 28 days of diagnosis, yielding a 28-day mortality of 37.4%. The median level of β2MG for all enrolled patients was 4.6 (interquartile range [IQR]: 2.9–8.5) mg/L. Higher β2MG levels were significantly associated with 28-day mortality when the β2MG level was analysed as a continuous variable (hazard ratio [HR]: 1.050; 95% confidence interval [CI]: 1.012–1.091; P = 0.010) and when it was categorized into tertiles (HR: 1.482; 95% CI: 1.069–2.045; P = 0.018). The serum β2MG level exhibited a diagnostic accuracy for predicting mortality that was not inferior to those of the Acute Physiology and Chronic Health Evaluation score (P = 0.153) and Sequential Organ Failure Assessment score (P = 0.114). Conclusions The level of serum β2MG is elevated and is an independent risk factor of 28-day mortality in patients with ARDS, suggesting that it has predictive value for the outcomes of these patients.

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