Thus, the potential harms currently and benefits of antiviral treatment have to be weighed very cautiously in patients with severe sepsis or septic shock.Key messages? Cytomegalovirus reactivation occurs in 40% of non-immunosuppressed CMV-seropositive critically ill patients with severe sepsis.? Cytomegalovirus reactivation had no relevant impact on mortality but was associated with increased length of stay in the ICU and in the hospital.? Cytomegalovirus reactivation was accompanied by Herpes simplex infection in 65.7% of cases.? Herpes simplex occurs earlier than CMV reactivation during severe sepsis.AbbreviationsACCP: American College of Chest Physicians; CI: confidence interval; CMV: cytomegalovirus; HR: hazard ratio; HSV: herpes simplex virus; LOS: length of stay; SAPS: Simplified Acute Physiology Score; SCCM: Society of Critical Care Medicine; SOFA: Simplified Organ Failure Assessment.
Competing interestsThis study was sponsored in part by Roche Pharma AG, Grenzach-Wyhlen, Germany. One of the co-authors (FR) was formerly employed by Roche Pharma AG, whose product is active against CMV infection, which was studied in the present work. There are no other competing interests.Authors’ contributionsAH designed and carried out the clinical study including data analysis, and was the responsible first author, with an unrestricted grant as mentioned above. HH recruited samples and is the corresponding author. IF was responsible for statistical analysis. RB performed the virological analysis (HSV PCR) and data analysis. RR recruited patients. FR was responsible for discussion and the literature search.
CM was responsible for statistical analysis. GJ interpreted the data. AK and KU recruited patients Entinostat and contributed to the discussion. KH co-designed the virological study and was responsible for virological monitoring, including the data analysis.NotesSee related commentary by Kalil and Florescu, http://ccforum.com/content/15/2/138AcknowledgementsThe authors would like to acknowledge the excellent technical assistance of Mrs. Andrea Baumann and Mrs. Elfriede Mikeler, who performed the virological assays. We would also like to thank Mrs. Susanne Schwarze and Mrs. Silvia Ziegler for collecting the clinical data.
Trauma patients may be affected by several conditions predisposing them to acute lung injury (ALI) and frequently fulfill all criteria for ALI proposed by the American-European Consensus Conference on Acute Respiratory Distress Syndrome (AECC) [1].