Prise en charge des complications aiguës sévères chez l’adulte mucoviscidosique
| Autor: | R. Kanaan, N. Desmazes-Dufeu, B. Zuber, Dominique Hubert, Jeanne Chapron, Daniel Dusser, Jean-Paul Mira, P.-R. Burgel |
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| Rok vydání: | 2011 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty business.industry medicine.medical_treatment Respiratory disease medicine.disease Intensive care unit Surgery law.invention Distal intestinal obstruction syndrome Chest tube Pneumothorax Respiratory failure law Intensive care medicine.artery medicine medicine.symptom Intensive care medicine business Bronchial artery |
| Zdroj: | Revue des Maladies Respiratoires. 28:503-516 |
| ISSN: | 0761-8425 |
| DOI: | 10.1016/j.rmr.2010.11.002 |
| Popis: | The natural history of cystic fibrosis (CF) may be associated both with acute respiratory complications (respiratory exacerbations, haemoptysis, pneumothorax) and with non-respiratory complications (distal intestinal obstruction syndrome, dehydration) that may result in hospitalizations. The aim of this article is to describe the main therapeutic approaches that are adopted in the management of acute complications occurring in CF adults, and to discuss indications for admission of these patients to intensive care units. Adult CF patients admitted to intensive care unit often benefit from antibiotic courses adapted to their chronic bronchial infection, especially when the hospitalization is related to respiratory disease (including haemoptysis and pneumothorax). Nutritional support, including hypercaloric diet, control of hyperglycemia and pancreatic enzyme supplementation is warranted. The recommended therapy for major haemoptysis is bronchial artery embolization. Patient with significant pneumothorax should have a chest tube inserted, while the treatment of distal intestinal obstruction syndrome will most often be medical. In case of respiratory failure, non-invasive ventilation is the preferred mode of ventilatory support because invasive ventilation is associated with poor outcomes. Therapeutic options should always have been discussed between the patient, family members and the CF medical team to allow for informed decision making. |
| Databáze: | OpenAIRE |
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