Document Detail


Management and long-term outcome of patients with chronic neuromuscular disease admitted to the intensive care unit for acute respiratory failure: a single-center retrospective study.
MedLine Citation:
PMID:  21740726     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Patients with chronic neuromuscular disease represent less than 10% of those receiving mechanical ventilation in the intensive care unit (ICU). Little has been reported regarding either ICU management of acute respiratory failure (ARF) in the era of noninvasive mechanical ventilation (NIV) or long-term outcomes.
OBJECTIVE: To describe the respiratory management of patients with chronic neuromuscular diseases admitted to our university hospital ICU for ARF, and the long-term outcomes.
METHODS: We retrospectively analyzed patients with chronic neuromuscular diseases admitted to our ICU for a first episode of ARF between January 1, 1996, and February 27, 2007. We assessed severity of illness on ICU admission, respiratory management during ICU stay, and outcomes on June 15, 2008.
RESULTS: During the study period, 87 patients (44 with hereditary and 43 with acquired neuromuscular diseases) had their first ARF episode that required ICU admission. In the hereditary-diseases group and the acquired-diseases group, respectively, the rates of NIV use during the ICU stay were 82% and 63% (P = .040), the intubation rates were 30% and 56% (P = .02), and the tracheotomy rates were 9% and 12% (difference not significant). At the final assessment (median 3 years) the mortality rate was 58%, and mortality was not significantly related to the type of neuromuscular disease. At final assessment, 46% of the patients were on NIV and 29% had tracheotomy.
CONCLUSIONS: In our ICU, chronic neuromuscular disease is an uncommon cause of ARF, for which we often use NIV. These patients had a low probability of death in the ICU. Long-term outcome was independent of the type of neuromuscular disease.
Authors:
Ghislain Flandreau; Gael Bourdin; Véronique Leray; Frédérique Bayle; Florent Wallet; Bertrand Delannoy; Gérard Durante; Bernard Vincent; Jack Barbier; Jean-François Burle; Sandrine Passant; Jean-Christophe Richard; Claude Guérin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Respiratory care     Volume:  56     ISSN:  0020-1324     ISO Abbreviation:  Respir Care     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-07-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  953-60     Citation Subset:  IM    
Affiliation:
Service de Réanimation Médicale et d'Assistance Respiratoire, Hôpital de la Croix Rousse, Lyon, France.
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