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Lee M, Kim S, Kwon OJ, Kim JH, Jeong I, Son JW, Na MJ, Yoon YS, Park HW, Kwon SJ. Treatment of Adenoviral Acute Respiratory Distress Syndrome Using Cidofovir With Extracorporeal Membrane Oxygenation. J Intensive Care Med 2016; 32:231-238. [PMID: 27903788 DOI: 10.1177/0885066616681272] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Adenovirus infections are associated with respiratory (especially upper respiratory) infection and gastrointestinal disease and occur primarily in infants and children. Although rare in adults, severe lower respiratory adenovirus infections including pneumonia are reported in specific populations, such as military recruits and immunocompromised patients. Antiviral treatment is challenging due to limited clinical experience and lack of well-controlled randomized trials. Several previously reported cases of adenoviral pneumonia showed promising efficacy of cidofovir. However, few reports discussed the efficacy of cidofovir in acute respiratory distress syndrome (ARDS). We experienced 3 cases of adenoviral pneumonia associated with ARDS and treated with cidofovir and respiratory support, including extracorporeal membrane oxygenation (ECMO). All 3 patients showed a positive clinical response to cidofovir and survival at 28 days. Cidofovir with early ECMO therapy may be a therapeutic option in adenoviral ARDS. A literature review identified 15 cases of adenovirus pneumonia associated with ARDS.
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Affiliation(s)
- Minhyeok Lee
- 1 Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
| | - Seulgi Kim
- 1 Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
| | - Oh Jung Kwon
- 1 Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
| | - Ji Hye Kim
- 1 Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
| | - Inbeom Jeong
- 1 Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
| | - Ji Woong Son
- 1 Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
| | - Moon Jun Na
- 1 Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
| | - Yoo Sang Yoon
- 2 Department of Thoracic surgery, Cancer Center, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea
| | - Hyun Woong Park
- 3 Division of Cardiology, Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Sun Jung Kwon
- 1 Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
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