This is a multicenter study with the aim to determine the prevalence of influenza-related invasive pulmonary aspergillosis in Swedish intensive care units and to assess the clinical impact of and risk factors for influenza-related invasive pulmonary aspergillosis
This is a multicenter prospective observational study conducted at 12 intensive care units (ICU) in Sweden. All patients \>18 years of age with a Polymerase Chain Reaction (PCR)-verified influenza A or B diagnosed up to 7 days before admission to the ICU or during ICU care, will be included in the study. A new clinical routine has been implemented at the study centers: During the ICU stay screening with Beta-D-glucan and Galactomannan in blood/serum will be performed twice weekly and a respiratory sample will be retrieved for fungal culture and microscopy once weekly. All results from collected samples will be available to the patient's attending physicians. Clinical and microbiological data will be collected, and the diagnosis of invasive aspergillosis will be made using predefined diagnostic criteria. Objectives: 1. To determine the prevalence of influenza-related invasive pulmonary aspergillosis in Swedish intensive care units 2. To assess the clinical impact of and risk factors for influenza-related invasive pulmonary aspergillosis
Study Type
OBSERVATIONAL
Enrollment
55
ICU at Mälarsjukhuset
Eskilstuna, Sweden
ICU at Helsingborgs lasarett
Helsingborg, Sweden
ICU at Länssjukhuset Ryhov
Jönköping, Sweden
Prevalence of proven or probable invasive pulmonary aspergillosis
Enrolled patients will be categorized as proven or probable invasive pulmonary aspergillosis at discharge from the ICU.
Time frame: From date of enrollment up to 90 days after enrollment
Sequential Organ Failure assessment Score (in patients diagnosed with proven/probable invasive pulmonary aspergillosis and those that were not)
Registered once daily. Range 0-24, a higher score indicates a higher mortality risk
Time frame: from date of admission to ICU to date of discharge from ICU, approximately 21 days
Use of mechanical ventilation (in patients diagnosed with proven/probable invasive pulmonary aspergillosis and those that were not)
Yes/No. Registered once daily.
Time frame: from date of admission to ICU to date of discharge from ICU, approximately 21 days
Use of non-invasive ventilation (in patients diagnosed with proven/probable invasive pulmonary aspergillosis and those that were not)
Yes/No. Registered once daily
Time frame: from date of admission to ICU to date of discharge from ICU, approximately 21 days
Use of vasopressor (in patients diagnosed with proven/probable invasive pulmonary aspergillosis and those that were not)pulmonary aspergillosis and those that were not)
Yes/No. Registered once daily.
Time frame: from date of admission to ICU to date of discharge from ICU, approximately 21 days
Use of renal replacement therapy (in patients diagnosed with proven/probable invasive pulmonary aspergillosis and those that were not)
Yes/No. Registered once daily.
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ICU at Universitetssjukhuset
Linköping, Sweden
ICU at Skånes universitetssjukhus
Lund, Sweden
ICU at Skånes universitetssjukhus
Malmö, Sweden
ICU at Universitetssjukhuset
Örebro, Sweden
ICU at Danderyds sjukhus
Stockholm, Sweden
ICU at Karolinska Universitetssjukhuset Huddinge
Stockholm, Sweden
ICU at Karolinska Universitetssjukhuset Solna
Stockholm, Sweden
...and 2 more locations
Time frame: from date of admission to ICU to date of discharge from ICU, approximately 21 days
Acute Respiratory Distress Syndrome (in patients diagnosed with proven/probable invasive pulmonary aspergillosis and those that were not)
Registered once daily, using the Berlin-definition (mild 200 mm Hg \< PaO2/FIO2 ≤ 300 mm Hg), moderate (100 mm Hg \< PaO2/FIO2 ≤ 200 mm Hg), and severe (PaO2/FIO2 ≤ 100 mm Hg)
Time frame: from date of admission to ICU to date of discharge from ICU, approximately 21 days
Days of ICU stay (in patients diagnosed with proven/probable invasive pulmonary aspergillosis and those that were not)
Median number of days
Time frame: from date of admission to ICU to date of discharge from ICU, approximately 21 days
ICU mortality (in patients diagnosed with proven/probable invasive pulmonary aspergillosis and those that were not)
Yes/No
Time frame: from date of admission to ICU to date of discharge from ICU, approximately 21 days
90-day mortality after ICU admission (in patients diagnosed with proven/probable invasive pulmonary aspergillosis and those that were not)
Yes/No
Time frame: from date of ICU admission to 90 days after ICU admission