Main characteristics observed in patients with hematologic diseases admitted to an intensive care unit of a Brazilian university hospital
| Autor: | Lídia Miranda Barreto, Vandack Nobre, Samuel Viana Coelho, Júlia Pereira Torga |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Critical Care and Intensive Care Medicine law.invention Hospitals University Sepsis law Intubation Intratracheal medicine Humans Intubation Hospital Mortality Respiratory system Intensive care medicine Retrospective Studies Mechanical ventilation Noninvasive Ventilation business.industry Retrospective cohort study General Medicine Length of Stay Middle Aged medicine.disease University hospital Hematologic Diseases Respiration Artificial Intensive care unit Intensive Care Units Logistic Models Treatment Outcome Editorial Emergency medicine Breathing Female Respiratory Insufficiency business Brazil |
| Zdroj: | Revista Brasileira de Terapia Intensiva |
| ISSN: | 0103-507X |
| Popis: | Objective:To evaluate the clinical characteristics of patients with hematological disease admitted to the intensive care unit and the use of noninvasive mechanical ventilation in a subgroup with respiratory dysfunction.Methods:A retrospective observational study from September 2011 to January 2014.Results:Overall, 157 patients were included. The mean age was 45.13 (± 17.2) years and 46.5% of the patients were female. Sixty-seven (48.4%) patients had sepsis, and 90 (57.3%) patients required vasoactive vasopressors. The main cause for admission to the intensive care unit was acute respiratory failure (94.3%). Among the 157 studied patients, 47 (29.9%) were intubated within the first 24 hours, and 38 (24.2%) underwent noninvasive mechanical ventilation. Among the 38 patients who initially received noninvasive mechanical ventilation, 26 (68.4%) were subsequently intubated, and 12 (31.6%) responded to this mode of ventilation. Patients who failed to respond to noninvasive mechanical ventilation had higher intensive care unit mortality (66.7% versus 16.7%; p = 0.004) and a longer stay in the intensive care unit (9.6 days versus 4.6 days, p = 0.02) compared with the successful cases. Baseline severity scores (SOFA and SAPS 3) and the total leukocyte count were not significantly different between these two subgroups. In a multivariate logistic regression model including the 157 patients, intubation at any time during the stay in the intensive care unit and SAPS 3 were independently associated with intensive care unit mortality, while using noninvasive mechanical ventilation was not.Conclusion:In this retrospective study with severely ill hematologic patients, those who underwent noninvasive mechanical ventilation at admission and failed to respond to it presented elevated intensive care unit mortality. However, only intubation during the intensive care unit stay was independently associated with a poor outcome. Further studies are needed to define predictors of noninvasive mechanical ventilation failure. |
| Databáze: | OpenAIRE |
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