ArticleAnnals of intensive care2021
Preemptive ganciclovir for mechanically ventilated patients with cytomegalovirus reactivation.
Article in Annals of intensive care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.
- Does treatment with antiviral medication affect mortality among immunocompetent individuals with cytomegalovirus reactivation? A systematic review and meta-analysis.BMC infectious diseases · 2025Pooled it
- Viral Reactivation in Immunocompetent Critically Ill Patients.Microorganisms · 2026Review
- Histological proof of pulmonary herpesvirus presence in patients with COVID-19- or influenza-related ARDS.Critical care (London, England) · 2026Article
- Higher prevalence of cytomegalovirus and Epstein-Barr virus in acute-on-chronic liver failure.JHEP reports : innovation in hepatology · 2026Article
- Time-series clustering analysis reveals distinct patterns of cytomegalovirus viremia in critically ill adults.Intensive care medicine experimental · 2026Article
- Host-Microbe Multiomic Profiling Predicts Mortality in Sepsis.American journal of respiratory and critical care medicine · 2026Article
- Associated Factors on Cytomegalovirus Reactivation in Patients with COVID-19 in the Intensive Care Unit.Mediterranean journal of hematology and infectious diseases · 2026Article
- The indirect effects of cytomegalovirus infection-mechanisms and consequences.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2025Article
- Observational
- Cytomegalovirus Reactivation in Critically Ill Patients With Acute Necrotizing Pancreatitis.Open forum infectious diseases · 2025Article
- The Landscape of lower respiratory tract herpesviruses in severe pneumonia patients: a multicenter, retrospective study with prospective validation.Critical care (London, England) · 2025Article
- Long-term prognosis following cytomegalovirus respiratory infection in immunocompromised and immunocompetent patients: a retrospective single-centre study.BMC infectious diseases · 2025Observational
- Cytomegalovirus reactivation in the lower respiratory tract as an independent risk factor for mortality in critically Ill patients.Critical care (London, England) · 2025Article
- Deciphering Positive Cytomegalovirus Immunoglobulin M Test Results in Immunocompetent Adults Hospitalized With Illness Suspicious for Acute Cytomegalovirus Infection: A Multihospital Study.Open forum infectious diseases · 2025Article
- Cytomegalovirus Blood DNAemia in Patients with Severe SARS-CoV-2 Pneumonia.Infectious disease reports · 2025Article
- What intensivists need to know about cytomegalovirus infection in immunocompromised ICU patients.Intensive care medicine · 2025Review
- Viral reactivations and fungal infections in nonresolving acute respiratory distress syndrome.European respiratory review : an official journal of the European Respiratory Society · 2025Review
- Cytomegalovirus reactivation in mechanically ventilated patients with or without SARS-CoV-2 infection: A retrospective cohort study.PloS one · 2025Article
- Active cytomegalovirus infection in mechanically ventilated patients with sepsis.BMC infectious diseases · 2024Article
- Comment to "Human cytomegalovirus seropositivity is associated with reduced patient survival during sepsis".Critical care (London, England) · 2024Article
Corrections and comments
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Authors and funding
21 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundThe effect of cytomegalovirus (CMV) reactivation on the length of mechanical ventilation and mortality in immunocompetent ICU patients requiring invasive mechanical ventilation remains controversial. The main objective of this study was to determine whether preemptive intravenous ganciclovir increases the number of ventilator-free days in patients with CMV blood reactivation.
methodsThis double-blind, placebo-controlled, randomized clinical trial involved 19 ICUs in France. Seventy-six adults ≥ 18 years old who had been mechanically ventilated for at least 96 h, expected to remain on mechanical ventilation for ≥ 48 h, and exhibited reactivation of CMV in blood were enrolled between February 5th, 2014, and January 23rd, 2019. Participants were randomized to receive ganciclovir 5 mg/kg bid for 14 days (n = 39) or a matching placebo (n = 37).
resultsThe primary endpoint was ventilator-free days from randomization to day 60. Prespecified secondary outcomes included day 60 mortality. The trial was stopped for futility based on the results of an interim analysis by the DSMB. The subdistribution hazard ratio for being alive and weaned from mechanical ventilation at day 60 for patients receiving ganciclovir (N = 39) compared with control patients (N = 37) was 1.14 (95% CI from 0.63 to 2.06; P = 0.66). The median [IQR] numbers of ventilator-free days for ganciclovir-treated patients and controls were 10 [0-51] and 0 [0-43] days, respectively (P = 0.46). Mortality at day 60 was 41% in patients in the ganciclovir group and 43% in the placebo group (P = .845). Creatinine levels and blood cells counts did not differ significantly between the two groups.
conclusionsIn patients mechanically ventilated for ≥ 96 h with CMV reactivation in blood, preemptive ganciclovir did not improve the outcome.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.