首頁 > 美迪醫訊 > 單純皰疹病毒肺部感染常見于使用機械性換氣的病人 |
單純皰疹病毒肺部感染常見于使用機械性換氣的病人 【?2007-06-01 發布?】 美迪醫訊
最新報道,單純皰疹病毒肺部感染常見于長期機械性換氣的病人。 巴黎的一個研究小組對至少接受5天機械性換氣的病人做了觀察性研究。對疑似嚴重肺部感染的病人進行了生物活檢。單純皰疹病毒支氣管肺炎的發生與口咽部的擦拭有關、通過支氣管活檢可發現支氣管肺泡細胞中存在特異性的包涵體。 在所有受檢的病人中超過一半的病人在呼吸道內發現單純皰疹病毒,并且21%的病人在研究期間發現單純皰疹病毒感染。診斷前機械性換氣的耐受的平均時間為14天。感染的危險因素有口咽部的損傷、喉部攜帶病毒、以及在支氣管鏡檢查中造成的肉眼可見的支氣管損傷。 此項研究刊登于美國呼吸重癥治療醫學雜志2007年5月刊。 來源:medinews.com Herpes Lung Infection Common in Ventilated Patients By medinews.com staff writers Herpes simplex virus (HSV) lung infection occurs fairly often in immunocompetent patients undergoing lengthy periods of mechanical ventilation, claims a new study. Researchers at the Groupe Hospitalier Pitie-Salpetriere (Paris, France) conducted a prospective observational study of all immunocompetent patients admitted to the hospital undergoing mechanical ventilation for at least five days. Biopsies were obtained for all who deteriorated clinically with suspected lung infection. HSV bronchopneumonitis was defined as this deterioration when associated with HSV in oropharyngeal swabs, or bronchial and HSV-specific nuclear inclusions in cells recovered during bronchoalveolar lavage or bronchial biopsies. HSV was detected in the respiratory track of more than half of these patients, and HSV bronchopneumonitis was diagnosed in 42 (21%) of the 201 who deteriorated clinically during the study period. The mean duration of mechanical ventilation before diagnosis was 14 days. Risk factors associated with HSV bronchopneumonitis were oral-labial lesions, HSV in the throat, and macroscopic bronchial lesions seen during bronchoscopy. At admission, patients who subsequently developed HSV bronchopneumonitis were comparable to those without the disease. However, their courses were more complicated and they had a longer duration of mechanical ventilation and spent more time in intensive care. The study was reported in the May 1, 2007, issue of the American Journal of Respiratory and Critical Care Medicine. 揑n non-immunocompromised patients requiring prolonged mechanical ventilation, some episodes of clinical deterioration--leading to the suspicion of bacterial ventilator-associated pneumonia--are in fact due to an infection of the lower respiratory tract by HSV,?said lead author Dr. Charles-Edouard Luyt. It is not yet known whether the isolation of HSV from lower respiratory tract samples of non-immunocompromised ventilated patients corresponds to bronchial contamination from the mouth and/or throat, local tracheobronchial excretion of HSV, or true HSV lung involvement (bronchopneumonitis) with its own morbidity/mortality. Related Links: Groupe Hospitalier Pitie-Salpetriere 《美迪醫訊》歡迎您參與新聞投稿,業務咨詢: 美迪醫療網業務咨詢
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