154 Cases Of Severe Viral Pneumonia Etiology And Clinical Characteristics Analysis

Objective To explore the viral etiology and clinical features of severe viral pneumonia that admitted to the PICU and required mechanical ventilation treatment, in the diagnosis and treatment is to provide reference, to offering references for Clinical diagnosis and treatment.Methods Prospective studies all the children who admitted in the PICU of chongqing medical university, diagnosis of severe pneumonia (SP), require mechanical ventilation treatment, in May 2013 to April 2013. Perfect the respiratory tract etiology examination, bacterial culture and fungal smears, analyze virology result and clinical characteristics.Results 1.In the 336 cases of severe pneumonia (SP), the viral pathogen positive rate was 45.8%(154/336), With a single virus infection 85.1%(131/154), two kinds of. virus co-infection 4.9%(23/154) at the same time.2. The top four viruses in the order:respiratory syncytial virus (RSV),33.1%(51/154); adenovirus (ADV),18.2%(28/154); parainfluenza virus (PIV),13.6%(21/154); Influenza virus (IV):13%(20/154).3. Severe viral pneumonia (SVP) prevalent in the winter and spring, the lower temperatures season in the chongqing area.4. The age of SP caused by different viruses have obvious differences (x2=65.2, P=0.000):SVP are commonly seen in the children who is younger than 5 years old, the age of children who have severe pneumonia caused by RSV is often less than 6 month, intensive adenovirus pneumonia, severe influenza pneumonia are commonly seen in the children who is younger than 2 years old, influenza SP are commonly seen in the older children.5. SVP pathogens have different prevalence characteristic (x2= 33,P= 0.000), the peak season of RSV and ADV infection are in winter and spring, the PIV and IV distributed throughout the year, did not see obvious trend.6. SP caused by different viruses, and the fever process (x2= 52.2, P= 0.000), the progress of the disease (x2= 46.3, P= 46.3) have obvious differences:the thermal path of SAP is significantly longer, virus co-infection could lead to prolonged the thermal path; the progression of the RSV or IV infection is faster than the other virus.7. In the 154 SVP patients, there are 55.2% (85/154) patients that have basic diseases, the congenital heart disease and the lung disease are more frequent.8. In the 154 child who have SVP, there are 45.5%(70/154) patients occurred secondary bacterial infections, the streptococcus pneumonia is in the lead.9. The most common complications of SVP is electrolyte disorder 48.7%(75/154), myocardial damage,29.8% (46/154), abnormal liver function,26%(40/154), toxic encephalopathy 24.7%(38/143).10. SP caused by different viruses required ventilation time and hospital stay was no significant difference, but the treatment costs (x2= 22.6, P= 22.6) have obvious difference, virus co-infection required more costs.11. SVP caused by different virus, the prognosis (x2=44.5, P= 0.000) are obviously different, the prognosis of severe adenovirus pneumonia was poor, which needs pay more attention.Conclusions 1.Virus is the main pathogen of severe pneumonia, top of the list is RSV, than ADV, than PIV.2. Severe viral pneumonia pathogen correlation with age and season.3. The children with SVP are often accompanied by basic diseases.4. Severe viral pneumonia pathogen, clinical features and prognosis are different.5. Two kinds of virus co-infection could make the thermal path extended and treatment cost rose.