Source: Annual Congress 2010 - Acute respiratory failure
Disease area: Respiratory critical care, Respiratory infections

Abstract

Introduction. Immunosuppression, nowdays concerning many patients, poses a major risk factor of respiratory complications including severe acute respiratory failure requiring ICU admission
Patients. Over a 4 year period, 46 patients (21 males, 25 females), 18-89 years old (mean 59) with haematological and rheumatic disorders, all of them considered immunocompromised, were admitted to our ICU due to acute respiratory failure. APACHE II score on admission, underlying disease, type of immunosuppression, blood and bronchial secretions cultures, chest x-ray, length of stay and outcome were recorded.
Results. The underlying disorder was predominantly lymphoma (16/46-34%). Immunosuppression was due to cell mediated immunity impairment following immunosuppressive treatment (mainly corticosteroids-38/46, 82%) and/ or neutropenia (18/46-39%). Respiratory failure was related to infection, pneumonia or sepsis, in 31/46 (67, 4%) and to non-infectious causes, mainly cardiogenic pulmonary oedema, in 15/46 (32.6%). The average APACHE II score was 21.3 (8-31) and diffuse alveolar infiltrates were the main findings in chest x-rays. Bronchial secretions cultures were positive in 25/46 (54.3%) and blood cultures were positive in 17/46 (36.9%). Length of stay was 14.6 days (1-58). Overall mortality was 28/46 (61%), higher in those who were admitted due to infection 22/31 (71%). The main cause of death was multiorgan failure (23/28).
Conclusion. Immunocompromised patients are a group that presents a real challenge for the ICU physician and cumulating experience may play an important role in improving outcome.

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Citations should be made in the following way:
T. Topalis, P. Vernikos, D. Xanthis, J. Pavleas, A. Skiada, G. Papaspiropoulou, E. Choli, J. Floros (Athens, Greece). Profile of the respiratory failure in immunocompromised patients in the ICU. Eur Respir J 2010; 36: Suppl. 54, 2292

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