Corticosteroid therapy in patients with primary viral pneumonia due to pandemic (H1N1) 2009 influenza

被引：55

作者：

Diaz, Emili ^{[1
]}

Martin-Loeches, Ignacio ^{[2
]}

Canadell, Laura ^{[3
]}

Vidaur, Loreto ^{[4
]}

Suarez, David ^{[5
]}

Socias, Lorenzo ^{[6
]}

Estella, Angel ^{[7
]}

Gil Rueda, Bernardo ^{[8
]}

Eugenio Guerrero, Jose ^{[9
]}

Valverdu-Vidal, Montserrat ^{[10
]}

Carlos Vergara, Juan ^{[11
]}

Jesus Lopez-Pueyo, Maria ^{[12
]}

Magret, Monica ^{[13
]}

Recio, Teresa ^{[14
]}

Lopez, Diego ^{[15
]}

Rello, Jordi ^{[16
]}

Rodriguez, Alejandro ^{[17
]}

机构：

[1] Hosp St Joan Despi Moises Broggi, Crit Care Dept, CIBERES, IISPV, Barcelona 08970, Spain

[2] Hosp Sabadell, Crit Care Dept, Barcelona 08208, Spain

[3] Hosp Univ Tarragona Joan XXIII, Dept Pharm, Tarragona 43005, Spain

[4] Hosp Donostia, Crit Care Dept, San Sebastian 20014, Spain

[5] Univ Autonoma Barcelona, Fundacio Parc Tauli, Epidemiol & Assessment Unit, Sabadell 08028, Spain

[6] Hosp Son Llatzer, Crit Care Dept, Palma De Mallorca, Illes Balears, Spain

[7] Hosp SAS, Crit Care Dept, Jerez de la Frontera 11407, Spain

[8] Hosp Morales Meseguer, Crit Care Dept, Murcia 30008, Spain

[9] Hosp Gregorio Maranon, Crit Care Dept, Madrid 28007, Spain

[10] Hosp Arnau Vilanova, Crit Care Dept, Lleida 25198, Spain

[11] Hosp Cruces, Crit Care Dept, Baracaldo 48903, Bizkaia, Spain

[12] Complejo Asistencial Univ Burgos, Crit Care Dept, Burgos 09005, Spain

[13] Hosp Univ St Joan Reus, Crit Care Dept, Tarragona 43206, Spain

[14] Hosp Gen San Pedro de Alcantara, Crit Care Dept, Caceres 10003, Spain

[15] Fdn Jimenez Diaz, Crit Care Dept, E-28040 Madrid, Spain

[16] Univ Autonoma Barcelona, CIBER Enfermedades Resp CIBERES, Hosp Univ Vall dHebron, Crit Care Dept, Barcelona 08035, Spain

[17] Hosp Univ Tarragona Joan XXIII, Crit Care Dept, Tarragona 43005, Spain

来源：

JOURNAL OF INFECTION | 2012年 / 64卷 / 03期

关键词：

Corticosteroid; Viral pneumonia; H1N1; Therapy; RESPIRATORY-DISTRESS-SYNDROME; COMMUNITY-ACQUIRED PNEUMONIA; A(H1N1) INFECTION; A H1N1; FAILURE; GLUCOCORTICOIDS; HYDROCORTISONE; GUIDELINES; MANAGEMENT; SEPSIS;

D O I：

10.1016/j.jinf.2011.12.010

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Objective: During the first pandemic, some patients with pandemic (H1N1) 2009 influenza were treated with corticosteroids. The objective of this study was to assess the effect on survival of corticosteroid therapy in patients with pandemic (H1N1) 2009 influenza. Methods: Prospective, observational, multicenter study performed in 148 ICU. Data were recorded in the GTEI/SEMICYUC registry. Adult patients with pandemic (H1N1) 2009 influenza confirmed by rt-PCR were included in the analysis. Database records specified corticosteroid type and reason for corticosteroid treatment. Results: 372 patients with the diagnosis of primary viral pneumonia and completed outcomes treated in an ICU were included in the database. Mechanical ventilation was used in 70.2% of the patients. 136 (36.6%) patients received corticosteroids after a diagnosis of primary viral pneumonia. Obesity (35.6% vs 47.8% p = 0.021) and asthma (7.6% vs 15.4% p = 0.018), were more frequent in the group treated with corticosteroids. A Cox regression analysis adjusted for severity and potential confounding factors found that the use of corticosteroid therapy was not significantly associated with mortality (HR = 1.06, 95% CI 0.626-1.801; p = 0.825). Conclusions: Corticosteroid therapy in a selected group of patients with primary viral pneumonia due to pandemic (H1N1) 2009 influenza does not improve survival. (C) 2012 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

引用

页码：311 / 318

页数：8

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