A CONTROLLED TRIAL OF AEROSOLIZED RIBAVIRIN IN INFANTS RECEIVING MECHANICAL VENTILATION FOR SEVERE RESPIRATORY SYNCYTIAL VIRUS-INFECTION
A CONTROLLED TRIAL OF AEROSOLIZED RIBAVIRIN IN INFANTS RECEIVING MECHANICAL VENTILATION FOR SEVERE RESPIRATORY SYNCYTIAL VIRUS-INFECTION
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DOI：
10.1056/nejm199107043250105
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发表时间：
1991-07-04
影响因子：
158.5
通讯作者：
PROBER, CG
中科院分区：
文献类型：
--
作者：
SMITH, DW;FRANKEL, LR;PROBER, CG
背景。尽管抗病毒剂利巴韦林改善了自发呼吸呼吸道合胞病毒感染的婴儿下呼吸道疾病的进程，但尚不清楚利巴韦林是否可以使需要机械型院子节的严重呼吸道合依性病毒疾病的婴儿受益。我们进行了随机，双盲的，安慰剂对照的评估，对利巴韦蛋白（每毫升20 mg）的评估，该评估是针对接收机械通气的婴儿进行呼吸衰竭的婴儿，这是由记录的呼吸道衰竭引起的，这是由呼吸道衰竭引起的。在招收的28名婴儿（平均[+/- SD]年龄，1.4 +/- 1.7个月）中，有7种潜在疾病使他们倾向于严重感染（平均年龄，3.0 +/- 2.6个月），而21个以前是正常的（平均年龄为0.8 +/- 0.9个月）。在接受利巴韦林的14名婴儿中，机械通气的平均持续时间为4.9天（在接受安慰剂的14天中为9.9天； P = 0.01），补充氧气使用的平均长度为8.7天（与之相比13.5天； p = 0.01）。医院住院时间的平均长度为治疗利巴韦林后的13.3天，安慰剂的平均长度为15.0（p = 0.04）。当仅考虑21名先前正常婴儿时，利巴韦林接受者的医院平均长度为9.0天，接受安慰剂的患者为15.3天（P = 0.005）。在由于严重的呼吸道合胞病毒感染而需要机械通气的婴儿中，用雾化的利巴韦林治疗减少了机械通气，氧处理和住院时间的持续时间。
Background. Although the antiviral agent ribavirin improves the course of lower respiratory tract disease in spontaneously breathing infants with respiratory syncytial virus infection, it is not known whether ribavirin can benefit infants with severe respiratory syncytial virus disease who require mechanical ventilation.Methods. We conducted a randomized, double-blind, placebo-controlled evaluation of ribavirin (20 mg per milliliter) administered continuously in aerosolized form to infants receiving mechanical ventilation for respiratory failure that was caused by documented respiratory syncytial virus infection.Results. Of the 28 infants (mean [+/- SD] age, 1.4 +/- 1.7 months) enrolled, 7 had underlying diseases predisposing them to severe infection (mean age, 3.0 +/- 2.6 months), and 21 were previously normal (mean age, 0.8 +/- 0.9 month). Among the 14 infants who received ribavirin, the mean duration of mechanical ventilation was 4.9 days (as compared with 9.9 days among the 14 who received placebo; P = 0.01), and the mean length of supplemental oxygen use was 8.7 days (as compared with 13.5 days; P = 0.01). The mean length of the hospital stay was 13.3 days after treatment with ribavirin and 15.0 with placebo (P = 0.04). When only the 21 previously normal infants were considered, the mean length of the hospital stay was 9.0 days for the ribavirin recipients and 15.3 days for those who received placebo (P = 0.005).Conclusions. In infants who require mechanical ventilation because of severe respiratory syncytial virus infection, treatment with aerosolized ribavirin decreases the duration of mechanical ventilation, oxygen treatment, and the hospital stay.