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Viral infections in the ICU
Charles-Edouard Luyt1, Alain Combes, Ania Nieszkowska
1Service de Réanimation Médicale, Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, and Université Paris 6-Pierre et Marie Curie, France. charles-edouard.luyt@psl.aphp.fr
Current Opinion in Critical Care
|September 13, 2008
Summary
In mechanically ventilated patients, Herpesviridae (Herpes simplex virus and cytomegalovirus) are often found but may not cause pneumonia. Reactivation without lung involvement is common, but some cases of viral bronchopneumonitis impact outcomes.
Area of Science:
- Virology
- Critical Care Medicine
- Pulmonology
Background:
- Pneumonia is a significant concern in mechanically ventilated patients.
- The role of viruses in nosocomial pneumonia remains debated.
- Herpesviridae are frequently detected in the respiratory tracts of these patients.
Purpose of the Study:
- To review the precise role of viruses as causes of pneumonia in mechanically ventilated patients.
- To differentiate between viral colonization and active viral disease.
- To assess the impact of viral infections on patient outcomes.
Main Methods:
- Literature review of studies on viral detection in mechanically ventilated patients.
- Analysis of viral pathogens, particularly Herpesviridae (herpes simplex virus, cytomegalovirus).
- Evaluation of evidence linking viral detection to pneumonia and patient outcomes.
Main Results:
- Herpesviridae are commonly recovered from the respiratory tract of mechanically ventilated patients.
- Viral detection does not always indicate active viral disease; colonization is frequent.
- A subset of patients experiences viral bronchopneumonitis, potentially impacting outcomes.
Conclusions:
- Respiratory viruses cause 10% of community-acquired pneumonia but not typically nosocomial pneumonia.
- Herpesviridae reactivation is common in ventilated patients, often without lung parenchymal involvement.
- Viral bronchopneumonitis in specific cases may affect outcomes, requiring further interventional studies.
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