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Use of Respiratory Viral Panels Does Not Impact Clinical Outcomes in ICU Patients

FEB 21, 2019 | MICHAELA FLEMING
Respiratory viral infections are a frequent cause of hospitalizations for adult patients and can lead to admission into the intensive care unit. In a new study, investigators from Wake Forest Baptist Medical Center in Winston-Salem, Noth Carolina, sought to determine if using respiratory viral panels to test for respiratory viral infections could improve clinical outcomes.

The results of the study were published in the journal Critical Care Medicine and presented in the research snapshot theater at the Society of Critical Care Medicine’s 48th Critical Care Congress.

The prospective, single-center, observational study was conducted from November 2017 through January 2018 at Wake Forest Baptist Medical Center. A total of 45 patients were included in the analysis, all of whom were admitted into the ICU with a diagnosis of pneumonia and for which a respiratory virus panel was obtained.

With a focus on determining if using point-of-care panels could improve stewardship and patient outcomes, the primary outcome of the study was to quantify the duration of therapy and defined daily doses of patients with respiratory virus infections compared with those without the infection.

The study results indicate that 14 of the 45 patients that met inclusion criteria (31.1%) were found to have a respiratory virus infection.

For individuals with respiratory bacterial cultures, more patients with a respiratory virus infection had positive cultures compared with those without a respiratory virus infection (7 of 8 vs. 9 of 23; p = 0.023).

The investigators note that there was no difference in the classification of pneumonia (p = 0.461) or Charleson Comorbidity Index (4 [2–5] vs. 4 [2–7], respectively; p = 0.711) between those with and without respiratory virus infections.

Additionally, there was no observable difference between those with and without respiratory virus infections in total defined daily doses (10 [6–17] vs. 11 [8–19], respectively; p = 0.320) and duration of therapy (6 [4–8] vs. 7 [5–10], respectively; p=0.248). Further, patients with a respiratory virus infection had less defined daily doses of anti-pseudomonal antibiotics (1 [0–3] vs. 3 [0–8], respectively; p = 0.040).

The study points out that no difference was seen in ventilator-free days (p = 0.510), hospital length-of-stay (p = 0.455), or 28-day mortality (p = 1.00).

“Diagnosis with [a respiratory virus infection] was not associated with a decrease in overall antibiotic exposure, however these patients were exposed to less anti-pseudomonal antibiotics,” the investigators concluded. “Utilization of [respiratory viral panels] in a critically ill patient population had no effect in clinical outcomes.”

The study, “Respiratory viral infection testing in critically ill patients diagnosed with pneumonia,” was presented on Monday, February 18, 2019, at the 48th Critical Care Congress in San Diego California.
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