This is a retrospective observational study over the period 1/2019 - 02/2024 with the aim of identifying patients with a predisposition to secondary infections.
As a reference center, Charité Universitaetsmedizin Berlin has been treating patients with the most severe form of acute respiratory failure, known as acute respiratory distress syndrome (ARDS), for more than 30 years. Despite lung-protective forms of ventilation and the use of extracorporeal procedures for oxygenation and decarboxylation (ECMO), mortality is around forty percent. In addition to the primary cause of ARDS, further infectious complications often develop during the course of the disease, which delay recovery. The aim of this study is to investigate infectious complications (ventilator-associated pneumonia, reactivation of Herpes viridae, pathogen resistance despite formally correct therapy, fungal infections) depending on the immune status.
Study Type
OBSERVATIONAL
Enrollment
200
Department of Anesthesiology and Intensive Care Medicine (CCM/CVK), Charité - University Medicine Berlin
Berlin, Germany
RECRUITINGHerpes simplex reactivation
semi-quantitatively with Herpes simplex (negative / slightly positive / positive and strongly positive) in blood or bronchial lavage
Time frame: 01/2019- 12/2025
Cytomegalovirus reactivation
as absolute copy number per milliliter of blood or bronchioalveolar lavage
Time frame: 01/2019- 12/2025
Epstein Barr virus reactivation
absolute copy number per milliliter of blood or bronchioalveolar lavage
Time frame: 01/2019- 12/2025
B cells (CD19 positive)
Absolute number per nanoliter and percentage of lymphocytes
Time frame: 01/2019- 12/2025
Natural killer cells Cells (CD16 pos)
Absolute number per nanoliter and percentage of lymphocytes.
Time frame: 01/2019- 12/2025
T helper cells (CD4)
Aabsolute number per nanoliter and percentage of lymphocytes
Time frame: 01/2019- 12/2025
Cytotoxic T cells (CD8)
Absolute number per nanoliter and percentage of lymphocytes
Time frame: 01/2019- 12/2025
HLA-DR expression on monocytes
in molecules per cell
Time frame: 01/2019- 12/2025
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Beginn weaning
Days until the first successful spontaneous breathing trial.
Time frame: 01/2019- 12/2025
Extracorporeal membrane oxygenation duration
Extracorporeal membrane oxygenation is measured in days
Time frame: 01/2019- 12/2025
Costs of treatment
Costs of treatment are measured by costs of particular microbiological diagnostics and therapy.
Time frame: 01/2019- 12/2025
Pathogen persistence after guideline-compliant therapy (yes/no)
Time frame: 01/2019- 12/2025
Ventilator-associated pneumonia (yes/no)
Time frame: 01/2019- 12/2025
Occurrence of fungal pneumonia (yes/no)
Time frame: 01/2019- 12/2025
Mortality
ITS mortality and hospital mortality are measured.
Time frame: 01/2019- 12/2025
Sequential Organ Failure Assessment (SOFA score)
Routine patient treatment data - score is measured numerically (0 - 24) Routine patient treatment data.
Time frame: 01/2019- 12/2025
Simplified Acute Physiology Score (SAPS II)
Routine patient treatment data - score is measured numerically (0 - 163)
Time frame: 01/2019- 12/2025
Pre-existing conditions
Classified recording of previous illnesses (e.g. haematological diseases, tumour diseases, chronic heart failure, etc.) from the medical file.
Time frame: 01/2019- 12/2025
Concomitant infections with therapy
Results of microbiological diagnostics (growth- and molecular-based diagnostics) by specifying the name of the pathogen.
Time frame: 01/2019- 12/2025
Volumes
Volumes administered, incl. transfusions and coagulation factors
Time frame: 01/2019- 12/2025
Ventilation parameters
Recording of ventilation parameters such as airway, ventilation mode and start of ventilation weaning.
Time frame: 01/2019- 12/2025
Catecholamine doses
Name of catecholamines, inotropes and vasopressors
Time frame: 01/2019- 12/2025
Number of catecholamine days
Number of days with dose of norepinephrine \> 0.1 µg/kg/min for more than 30 min or equivalent dose of other catecholamines.
Time frame: 01/2019- 12/2025
Recording of end organ damage such as liver and kidney failure
Organ damage measured by routine laboratory
Time frame: 01/2019- 12/2025
Diagnoses during the intensive care stay
Diagnoses as the cause of ARDS, but also newly acquired diagnoses such as critical illness myopathy / polyneuropathy, renal failure.
Time frame: 01/2019- 12/2025
Administration of immunosuppressants
Administration of immunosuppressants like corticosteroid, chemotherapy, monoclonal antibodies within the last 3 months.
Time frame: 01/2019- 12/2025