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Predictors of outcome in patients with cystic fibrosis requiring endotracheal intubation.
MedLine Citation:
PMID:  23323684     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: Acute severe clinical deterioration of patients with cystic fibrosis (CF) may mandate endotracheal intubation. We evaluated the benefits of intubation by examining which pre-admission parameters were associated with ICU outcome; and assessing the potential benefits of intubation for survivors in terms of time from ICU discharge to death. METHODS: A retrospective analysis of data from a single centre was undertaken. RESULTS: Thirty patients required intubation on 34 occasions (8 per 1000 admissions). Eleven patients died in ICU, and 7 after ICU but not hospital discharge. 59% of 22 patients intubated for pneumothorax and/or haemoptysis survived to hospital discharge. Of the twelve intubated for infective exacerbations, 33% survived to hospital discharge. Those who died after hospital discharge survived 447 days. There were no significant differences for survivors in reasons for intubation; colonising organism; frequency of infective exacerbations, severity of illness or pulmonary physiology. Osteoporosis and a greater fall in BMI over the 24 months prior were more frequent in non-survivors. CONCLUSIONS: Patients with CF developing haemoptysis and/or pneumothorax should be admitted to ICU and intubated promptly should this be required. Chronic disease markers may be more relevant prognostically than rates of hospitalisation or FEV1 decline which should not be bars to invasive ventilation.
Authors:
Andrew Jones; Diana Bilton; Timothy W Evans; Simon J Finney
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-17
Journal Detail:
Title:  Respirology (Carlton, Vic.)     Volume:  -     ISSN:  1440-1843     ISO Abbreviation:  Respirology     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9616368     Medline TA:  Respirology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.
Affiliation:
Department of Cystic fibrosis, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, United Kingdom; NIHR Biomedical Research Unit into Advanced Lung Disease, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, United Kingdom.
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