The burden of respiratory syncytial virus(RSV)disease is widely recognized.Main risk factors for severe disease,such as extreme ages,chronic cardiopulmonary conditions,and immunosuppression,typically coincide withpoor...The burden of respiratory syncytial virus(RSV)disease is widely recognized.Main risk factors for severe disease,such as extreme ages,chronic cardiopulmonary conditions,and immunosuppression,typically coincide withpoorer outcomes.While the majority of RSV hospitalizations involve healthy children,a higher proportion ofhospitalized adults with underlying conditions need intensive care.Presently,treatment primarily consists ofsupportive measures.RSV-induced wheezing should be distinguished from respiratory tract thickening,withoutresponse to bronchodilators.Obstructive RSV disease frequently overlaps with viral pneumonia.Non-invasivemechanical ventilation and high-flow oxygen therapy represented significant advancements in the managementof severe RSV disease in children and may also hold considerable importance in specific phenotypes of RSV diseasein adults.Most severe infections manifest with refractory hypoxemia necessitating more advanced ventilatorysupport and/or extracorporeal membrane oxygenation therapy.Although bacterial co-infection rates are low,they have been associated with worse outcomes.Antibiotic prescription rates are high.Accurately diagnosingbacterial co-infections remains a challenge.Current evidence and antibiotic stewardship policies advise againstindiscriminate antibiotic usage,even in severe cases.The role of currently developing antiviral therapies in severeRSV disease will be elucidated in the coming years,contingent upon the success of new vaccines and immunepassive strategies involving nirsevimab.展开更多
In a rapidly changing world,the role of intensive care has become increasingly relevant.Critical care medicine was born during the polio pandemic nearly 50 years ago and the COVID-19 pandemic has stringed its visibili...In a rapidly changing world,the role of intensive care has become increasingly relevant.Critical care medicine was born during the polio pandemic nearly 50 years ago and the COVID-19 pandemic has stringed its visibility.In this issue,a distinguished selection of the world’s leading experts will address some of the most intriguing issues,sharing their insights and experience in a collection of original articles,narrative reviews,and systematic reviews focusing on hot topics in intensive care units(ICU).Developing and tropical countries have particularities that need to be addressed.Malaria,dengue,and causes of unknown origin fever in this setting are detailed in three articles in the current issue.展开更多
文摘The burden of respiratory syncytial virus(RSV)disease is widely recognized.Main risk factors for severe disease,such as extreme ages,chronic cardiopulmonary conditions,and immunosuppression,typically coincide withpoorer outcomes.While the majority of RSV hospitalizations involve healthy children,a higher proportion ofhospitalized adults with underlying conditions need intensive care.Presently,treatment primarily consists ofsupportive measures.RSV-induced wheezing should be distinguished from respiratory tract thickening,withoutresponse to bronchodilators.Obstructive RSV disease frequently overlaps with viral pneumonia.Non-invasivemechanical ventilation and high-flow oxygen therapy represented significant advancements in the managementof severe RSV disease in children and may also hold considerable importance in specific phenotypes of RSV diseasein adults.Most severe infections manifest with refractory hypoxemia necessitating more advanced ventilatorysupport and/or extracorporeal membrane oxygenation therapy.Although bacterial co-infection rates are low,they have been associated with worse outcomes.Antibiotic prescription rates are high.Accurately diagnosingbacterial co-infections remains a challenge.Current evidence and antibiotic stewardship policies advise againstindiscriminate antibiotic usage,even in severe cases.The role of currently developing antiviral therapies in severeRSV disease will be elucidated in the coming years,contingent upon the success of new vaccines and immunepassive strategies involving nirsevimab.
文摘In a rapidly changing world,the role of intensive care has become increasingly relevant.Critical care medicine was born during the polio pandemic nearly 50 years ago and the COVID-19 pandemic has stringed its visibility.In this issue,a distinguished selection of the world’s leading experts will address some of the most intriguing issues,sharing their insights and experience in a collection of original articles,narrative reviews,and systematic reviews focusing on hot topics in intensive care units(ICU).Developing and tropical countries have particularities that need to be addressed.Malaria,dengue,and causes of unknown origin fever in this setting are detailed in three articles in the current issue.
