Severe acute respiratory distress syndrome (SARS): A critical care perspective

Manocha, Sanjay; Walley, Keith R.; Russell, James A.

doi:10.1097/01.ccm.0000091929.51288.5f

Cited by 65 publications

(51 citation statements)

References 24 publications

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“…Ortiz and collaborators [32] Hospital 12 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23) Limitation of therapy in-hospital, n (%) DNR 72 (11.9) WH/WD 57 (9.4) about 28,000 adults are hospitalized for influenza-associated critical illness in the USA annually. A recent biasadjusted meta-analysis [33] confirmed that influenza vaccine was effective in preventing hospitalization from influenza and/or pneumonia and all-cause mortality in community-dwelling elderly.…”

Section: Discussionmentioning

confidence: 99%

“…Whereas this definition of SARI may prove practical for surveillance systems, it provides little information for intensive care physicians regarding the nature of infections, the spectrum of severity, or the diagnostic and treatment strategies used for the subset of these patients that ultimately requires intensive care unit (ICU) admission. Indeed, only a subset of the patients with SARI will require ICU admission for oxygen therapy or mechanical ventilation; a smaller subset will develop acute respiratory distress syndrome and sepsis and an even smaller proportion will require adjunctive treatments [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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The Intensive Care Global Study on Severe Acute Respiratory Infection (IC-GLOSSARI): a multicenter, multinational, 14-day inception cohort study

Sakr¹,

Ferrer

Reinhart³

et al. 2016

Intensive Care Med

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Purpose: In this prospective, multicenter, 14-day inception cohort study, we investigated the epidemiology, patterns of infections, and outcome in patients admitted to the intensive care unit (ICU) as a result of severe acute respiratory infections (SARIs). Methods:All patients admitted to one of 206 participating ICUs during two study weeks, one in November 2013 and the other in January 2014, were screened. SARI was defined as possible, probable, or microbiologically confirmed respiratory tract infection with recent onset dyspnea and/or fever. The primary outcome parameter was in-hospital mortality within 60 days of admission to the ICU. Results:Among the 5550 patients admitted during the study periods, 663 (11.9 %) had SARI. On admission to the ICU, Gram-positive and Gram-negative bacteria were found in 29.6 and 26.2 % of SARI patients but rarely atypical bacteria (1.0 %); viruses were present in 7.7 % of patients. Organ failure occurred in 74.7 % of patients in the ICU, mostly respiratory (53.8 %), cardiovascular (44.5 %), and renal (44.6 %). ICU and in-hospital mortality rates in patients with SARI were 20.2 and 27.2 %, respectively. In multivariable analysis, older age, greater severity scores at ICU admission, and hematologic malignancy or liver disease were independently associated with an increased risk of in-hospital death, whereas influenza vaccination prior to ICU admission and adequate antibiotic administration on ICU admission were associated with a lower risk.*Correspondence: yasser.sakr@med.uni-jena.de 1 Department of Anesthesiology and Intensive Care, Uniklinikum Jena, Erlanger Allee 103, 07743 Jena, Germany Full list of author information is available at the end of the article Take-home message: Admission to the ICU for SARI is common and associated with high morbidity and mortality rates. We identified several risk factors for in-hospital death that may be useful for risk stratification in these patients.On behalf of the IC-GLOSSARI Investigators and the Trials Group of the European Society of Intensive Care (ESICM), Rue Belliard, 19, 1040 Brussels, Belgium. Email: research@esicm.org.A complete list of IC-GLOSSARI investigators is provided in the "Appendix". Conclusions:Admission to the ICU for SARI is common and associated with high morbidity and mortality rates. We identified several risk factors for in-hospital death that may be useful for risk stratification in these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Intensive Care Global Study on Severe Acute Respiratory Infection (IC-GLOSSARI): a multicenter, multinational, 14-day inception cohort study

Sakr¹,

Ferrer

Reinhart³

et al. 2016

Intensive Care Med

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“…This superspreading event is thought to be related to the administration of a nebulized bronchodilator to the index case, together with overcrowding and poor ventilation in the hospital ward. Many cases of nosocomial SARS-CoV transmission between healthcare workers and patients occurred in intensive care units, where there is particularly close contact between healthcare workers and patients [52][53][54][55][56].…”

Section: Transmissionmentioning

confidence: 99%

SARS: clinical presentation, transmission, pathogenesis and treatment options

2006

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SARS (severe acute respiratory syndrome) appeared as the first emerging infectious disease of this century. It is fortunate that the culprit virus can be grown without much difficulty from a commonly used cell line, allowing an unlimited supply of isolates for further molecular studies and leading to the development of sensitive diagnostic assays. How the virus has successfully jumped the species barrier is still a mystery. The superspreading events that occurred within hospital, hotel and high-density housing estate opens a new chapter in the mechanisms and routes of virus transmission. The old practice of quarantine proved to be still useful in controlling the global outbreak. Despite all the available sophisticated tests, alertness with early recognition by healthcare workers and prompt isolation of suspected cases is still the most important step for containing the spread of the infection. Although the rapidly evolving outbreak did not allow the conducting of systematic clinical trails to evaluate treatment options, the accumulated experience on managing SARS patients will improve the clinical outcome should SARS return. Although SARS led to more than 700 deaths worldwide, the lessons learnt have prepared healthcare systems worldwide to face future emerging and re-emerging infections.

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“…15 Neutrophilia and lymphopenia are similarly associated with inflammation that accompanies bacterial sepsis 16,17 and viral infections. [18][19][20] Thus, the clinical data on IL-6 and the animal models of IL-6 transgenics and knockouts suggest that IL-6 plays an important role in the pathogenesis of autoimmune and other proinflammatory diseases.…”

Section: Introductionmentioning

confidence: 99%