Journal ArticleDOI
Early Corticosteroids in Severe Influenza A/H1N1 Pneumonia and Acute Respiratory Distress Syndrome
Christian Brun-Buisson,Jean-Christophe M. Richard,Alain Mercat,Anne C. M. Thiébaut,Laurent Brochard +4 more
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TLDR
This study provides no evidence of a beneficial effect of corticosteroids in patients with ARDS secondary to influenza pneumonia, but suggests that very early corticosterone therapy may be harmful.Abstract:
Rationale: Despite their controversial role, corticosteroids are often administered to patients with adult respiratory distress syndrome (ARDS) secondary to viral pneumonia.Objectives: To analyze the impact of corticosteroid therapy on outcomes of patients having ARDS associated with influenza A/H1N1 pneumonia.Methods: Patients from the French registry of critically ill patients with influenza A/H1N1v 2009 infection were selected if fulfilling criteria for ARDS, excluding patients having other indication for corticosteroids, or decompensated underlying disease as the primary cause for intensive care unit admission. Survival to hospital discharge was analyzed using Cox regression, accounting for the time to administration of steroids, and after adjustment on the propensity for receiving steroid therapy.Measurements and Main Results: Of 208 patients with ARDS, 83 (39.9%) received corticosteroids (median initial dose of 270 mg equivalent hydrocortisone per day for a median of 11 d). Steroid therapy was assoc...read more
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Into the Eye of the Cytokine Storm
Jennifer R. Tisoncik,Marcus J. Korth,Cameron P. Simmons,Jeremy Farrar,Thomas R. Martin,Michael G. Katze +5 more
TL;DR: How high-throughput genomic methods are revealing the importance of the kinetics of cytokine gene expression and the remarkable degree of redundancy and overlap in cytokine signaling is highlighted.
Journal ArticleDOI
Corticosteroid Therapy for Critically Ill Patients With Middle East Respiratory Syndrome
Yaseen M. Arabi,Yasser Mandourah,Fahad Al-Hameed,Anees Sindi,Ghaleb A. Almekhlafi,Mohamed A. Hussein,Jesna Jose,Ruxandra Pinto,Awad Al-Omari,Ayman Kharaba,Abdullah Almotairi,Al Khatib K,Basem Alraddadi,Sarah Shalhoub,Ahmed Abdulmomen,Ismeal Qushmaq,Ahmed Mady,Othman Solaiman,Abdulsalam M. Al-Aithan,Rajaa Al-Raddadi,Ahmed Ragab,Hanan H. Balkhy,Al Harthy A,Ahmad M. Deeb,Al Mutairi H,Abdulaziz Al-Dawood,Laura Merson,Frederick G. Hayden,Frederick G. Hayden,Rob Fowler +29 more
TL;DR: Corticosteroid therapy in patients with MERS was not associated with a difference in mortality after adjustment for time‐varying confounders but was associated with delayed MERS coronavirus RNA clearance.
Journal ArticleDOI
The cytokine storm of severe influenza and development of immunomodulatory therapy.
TL;DR: This work reviews the current literature on how various effectors of the immune system initiate the cytokine storm and exacerbate pathological damage in hosts and some of the current immunomodulatory strategies for the treatment of cytokine storms in severe influenza.
Journal ArticleDOI
Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenzaa
Timothy M. Uyeki,Henry H. Bernstein,John S. Bradley,John S. Bradley,Janet A. Englund,Thomas M. File,Alicia M. Fry,Stefan Gravenstein,Frederick G Hayden,Scott A. Harper,Jon Mark Hirshon,Michael G. Ison,B Lynn Johnston,Shandra L Knight,Allison McGeer,Laura E. Riley,Cameron R. Wolfe,Paul E. Alexander,Paul E. Alexander,Andrew T. Pavia +19 more
TL;DR: These clinical practice guidelines are an update of the guidelines published by the Infectious Diseases Society of America in 2009 and address new information regarding diagnostic testing, treatment and chemoprophylaxis with antiviral medications, and issues related to institutional outbreak management for seasonal influenza.
Journal ArticleDOI
Clinical Course and Outcomes of Critically Ill Patients With Middle East Respiratory Syndrome Coronavirus Infection
Yaseen M. Arabi,Ahmed A. Arifi,Hanan H. Balkhy,Hani K. Najm,Abdulaziz Al-Dawood,Ala’a Ghabashi,Hassan Hawa,Adel Alothman,Abdulaziz Al Khaldi,Basel Al Raiy +9 more
TL;DR: In a study of patients hospitalized with suspected Middle East respiratory syndrome coronavirus infection, those with confirmed disease had preexisting comorbid conditions and required mechanical treatment for these conditions.
References
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Journal ArticleDOI
The American-European Consensus Conference on ARDS: Definitions, mechanisms, relevant outcomes, and clinical trial coordination
Gordon R. Bernard,Antonio Artigas,Kenneth L. Brigham,J. Carlet,K. Falke,L. Hudson,M. Lamy,J. R. LeGall,Alan H. Morris,Roger G. Spragg +9 more
TL;DR: The acute respiratory distress syndrome (ARDS), a process of nonhydrostatic pulmonary edema and hypoxemia associated with a variety of etiologies, carries a high morbidity, mortality, and financial cost.
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Relaxing the Rule of Ten Events per Variable in Logistic and Cox Regression
TL;DR: A large simulation study of other influences on confidence interval coverage, type I error, relative bias, and other model performance measures found a range of circumstances in which coverage and bias were within acceptable levels despite less than 10 EPV.
Journal ArticleDOI
Critically ill patients with 2009 influenza A(H1N1) infection in Canada.
Anand Kumar,Ryan Zarychanski,Ruxandra Pinto,Deborah J. Cook,John C. Marshall,Jacques Lacroix,Tom Stelfox,Sean M. Bagshaw,Karen Choong,Francois Lamontagne,Alexis F. Turgeon,Stephen E. Lapinsky,Stéphane P. Ahern,Orla Smith,Faisal Siddiqui,Philippe Jouvet,Kosar Khwaja,Lauralyn McIntyre,Kusum Menon,Jamie Hutchison,David Hornstein,Ari R. Joffe,François Lauzier,Jeffrey M. Singh,Tim Karachi,Kim Wiebe,Kendiss Olafson,Clare D. Ramsey,Sat Sharma,Peter Dodek,Maureen O. Meade,Richard I. Hall,Robert A. Fowler +32 more
TL;DR: Critical illness due to 2009 influenza A(H1N1) in Canada occurred rapidly after hospital admission, often in young adults, and was associated with severe hypoxemia, multisystem organ failure, a requirement for prolonged mechanical ventilation, and the frequent use of rescue therapies.
Journal ArticleDOI
Avian influenza A (H5N1) infection in humans
John H. Beigel,Jeremy Farrar,Aye Maung Han,Frederick G. Hayden,Randy Hyer,Menno D. de Jong,Sorasak Lochindarat,Thi Kim Tien Nguyen,Tran Hien Nguyen,Tinh Hien Tran,Angus Nicoll,Sok Touch,Kwok-Yung Yuen +12 more
TL;DR: The writing committee consisted of the following: John H. Beigel, M.D., National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md, and Jeremy Farrar, D.Phil., Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
Journal ArticleDOI
Efficacy and Safety of Corticosteroids for Persistent Acute Respiratory Distress Syndrome
Kenneth P. Steinberg,Leonard D. Hudson,Richard B. Goodman,Catherine L. Hough,Paul N. Lanken,Robert C. Hyzy,B. Taylor Thompson,Marek Ancukiewicz +7 more
TL;DR: A multicenter, randomized controlled trial of corticosteroids in patients with persistent acute respiratory distress syndrome found that methylprednisolone improved survival and biochemical markers of inflammation and fibroproliferation, and infectious complications.
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