Year in review in Intensive Care Medicine 2006. II. Infections and sepsis haemodynamics elderly invasive and noninvasive mechanical ventilation weaning ARDS

摘要

Cameron et al. [ ] investigated the possible role of viruses in 107 episodes of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). They used modern diagnostic tests, including immunofluorescence assay and polymerase chain reaction, on nasopharyngeal aspirates. They identified infections in 64% of cases, with viruses as probable responsible pathogens in 43%: influenza type A (13%) and rhinovirus (8%) were the most common organisms. Bacteria were found in 23% of cases, with as the most common pathogen (11%). The authors failed to find significant differences in clinical characteristics and outcome between virus-infected and noninfected patients. In his related editorial, Luyt [ ] comments more generally on virus in intensive care unit (ICU) patients, emphasizing (1) the questionable relationship between viral diseases and outcome, (2) the doubtful reliability of modern diagnostic tests with a risk of false-positive results and (3) as a consequence, the relevance of viral detection in respiratory tract secretions: detection of a virus does not mean infection.