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Main characteristics observed in patients with hematologic diseases admitted to an intensive care unit of a Brazilian university hospital.

Barreto LM, Torga JP, Coelho SV, Nobre V - Rev Bras Ter Intensiva (2015)

Bottom Line: Overall, 157 patients were included.Baseline severity scores (SOFA and SAPS 3) and the total leukocyte count were not significantly different between these two subgroups.However, only intubation during the intensive care unit stay was independently associated with a poor outcome.

View Article: PubMed Central - PubMed

Affiliation: Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, BR.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus

Mortality in the intensive care unit and hospital among 157 hematologic patientsaccording to the ventilatory support received during the intensive care unitstay.ICU - intensive care unit; NIMV - noninvasive mechanical ventilation; IMV -invasive mechanical ventilation.
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f01: Mortality in the intensive care unit and hospital among 157 hematologic patientsaccording to the ventilatory support received during the intensive care unitstay.ICU - intensive care unit; NIMV - noninvasive mechanical ventilation; IMV -invasive mechanical ventilation.

Mentions: Among the 38 patients who initially received NIMV, 26 (68.43%) were subsequentlyintubated and 12 (31.57%) responded favorably to this mode of ventilation. Overall, ICUmortality and hospital mortality were 47.8% and 73.2%, respectively (Figure 1). As shown in figure 1, overall mortality increased from the subgroup of patients with noneed for mechanical ventilator support during the ICU stay (lowest mortality, 7.1%) tothe those subgroups receiving any type of ventilator support, either non-invasive orinvasive (mortality as high as 69.3%).


Main characteristics observed in patients with hematologic diseases admitted to an intensive care unit of a Brazilian university hospital.

Barreto LM, Torga JP, Coelho SV, Nobre V - Rev Bras Ter Intensiva (2015)

Mortality in the intensive care unit and hospital among 157 hematologic patientsaccording to the ventilatory support received during the intensive care unitstay.ICU - intensive care unit; NIMV - noninvasive mechanical ventilation; IMV -invasive mechanical ventilation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4592114&req=5

f01: Mortality in the intensive care unit and hospital among 157 hematologic patientsaccording to the ventilatory support received during the intensive care unitstay.ICU - intensive care unit; NIMV - noninvasive mechanical ventilation; IMV -invasive mechanical ventilation.
Mentions: Among the 38 patients who initially received NIMV, 26 (68.43%) were subsequentlyintubated and 12 (31.57%) responded favorably to this mode of ventilation. Overall, ICUmortality and hospital mortality were 47.8% and 73.2%, respectively (Figure 1). As shown in figure 1, overall mortality increased from the subgroup of patients with noneed for mechanical ventilator support during the ICU stay (lowest mortality, 7.1%) tothe those subgroups receiving any type of ventilator support, either non-invasive orinvasive (mortality as high as 69.3%).

Bottom Line: Overall, 157 patients were included.Baseline severity scores (SOFA and SAPS 3) and the total leukocyte count were not significantly different between these two subgroups.However, only intubation during the intensive care unit stay was independently associated with a poor outcome.

View Article: PubMed Central - PubMed

Affiliation: Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, BR.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus