The morbidity and mortality rates for patients suffering from severe influenza-related acute respiratory distress syndrome (ARDS) are high. Additionally, nosocomial lower respiratory tract infections (NLRTI) make clinical management more difficult and may even make their results worse. Examining the clinical characteristics and effects of NLRTI in patients with severe influenza-related acute respiratory distress syndrome was the goal of this study. Methods: This retrospective observational study was approved by the institutional review board and was carried out in eight Taiwanese medical centers. Participants were recruited from intensive care units (ICUs) with influenza pneumonia that was virology-proven between January 1 and March 31, 2016. All ARDS patients who needed invasive mechanical ventilation but did not have bacterial community- acquired pneumonia (CAP) were also examined. Clinical outcomes, critical illness data, and baseline characteristics were documented. In conclusion, we discovered that NLRTI in influenza-related ARDS is independently predicted by the use of immunosuppressants prior to influenza infection, ECMO use, and higher steroid dosage following ARDS. Additionally, patients with severe influenza who have NLRTI have worse outcomes.

acute respiratory distress syndrome, influenza, mortality, nosocomial lower respiratory tract infection.