Prevalence and development of chronic critical illness in acute patients admitted to a respiratory intensive care setting

Autor: Stefania Costi, Filippo Gozzi, Gaia Cappiello, Alessandro Andreani, Riccardo Fantini, Roberto Tonelli, L. Musarò, Ivana Castaniere, Alessandro Marchioni, Enrico Clini, Luca Tabbì, Antonia Sdanganelli
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
ARDS
medicine.medical_treatment
Respiratory failure
Severity of Illness Index
Respiratory intensive care unit
0302 clinical medicine
Mechanical ventilation
Tracheostomy
Drug Resistance
Multiple
Bacterial
Prevalence
030212 general & internal medicine
Prospective Studies
Prospective cohort study
Chronic critical illness
Ultrasonography
Aged
80 and over
education.field_of_study
Respiratory Care Units
Acute respiratory distress syndrome
Middle Aged
Shock
Septic
Hospitalization
C-Reactive Protein
Italy
Acute Disease
Female
Respiratory Insufficiency
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Critical Illness
Population
Diaphragm
03 medical and health sciences
Internal medicine
Intensive care
medicine
Humans
education
Aged
lcsh:RC705-779
business.industry
Septic shock
Pneumonia
lcsh:Diseases of the respiratory system
medicine.disease
Respiration
Artificial
030228 respiratory system
Chronic Disease
business
Zdroj: Pulmonology, Vol 26, Iss 3, Pp 151-158 (2020)
ISSN: 2531-0437
Popis: Introduction Chronic Critical Illness (chronic CI) is a condition associated to patients surviving an episode of acute respiratory failure (ARF). The prevalence and the factors associated with the development of chronic CI in the population admitted to a Respiratory Intensive Care Unit (RICU) have not yet been clarified. Methods An observational prospective cohort study was undertaken at the RICU of the University Hospital of Modena (Italy). Patients mechanically ventilated with ARF in RICU were enrolled. Demographics, severity scores (APACHEII, SOFA, SAPSII), and clinical condition (septic shock, pneumonia, ARDS) were recorded on admission. Respiratory mechanics and inflammatory-metabolic blood parameters were measured both on admission and over the first week of stay. All variables were tested as predictors of chronic CI through univariate and multivariate analysis. Results Chronic CI occurred in 33 out of 100 patients observed. Higher APACHEII, the presence of septic shock, diaphragmatic dysfunction (DD) at sonography, multidrug-resistant (MDR) bacterial infection, the occurrence of a second infection during stay, and a C-reactive protein (CRP) serum level inceasing 7 days over admission were associated with chronic CI. Septic shock was the strongest predictor of chronic CI (AUC = 0.92 p Conclusions Chronic CI is frequent in patients admitted to RICU and mechanically ventilated due to ARF. Infection-related factors seem to play a major role as predictors of this syndrome.
Databáze: OpenAIRE
Externí odkaz: