Source: Annual Congress 2002 - Treatment and outcome of acute respiratory failure in chronic disease
Disease area: Respiratory critical care, Respiratory infections

Abstract

Acute respiratory failure in severe pulmonary tuberculosis is an unusual indication of mechanical ventilation (MV), but it may be a life saving procedure.
Aim of the study: To evaluate the particularities of the patients with pulmonary tuberculosis and respiratory failure who needed a type of ventilatory support.
Materials and methods: 8 patients (5 women) with pulmonary tuberculosis admitted in the Respiratory ICU with severe acute respiratory failure needing MV in the last two years. All but one (a 64 years old woman) were young (22-39 years), and had no other pathology responsible for the respiratory failure. Protein-caloric malnutrition was the most frequent co morbidity. Patients have been mechanically ventilated most of the time in an Assist/Controlled mode, the duration of MV being 9-54 days (mean 21 days). 6 patients suffered tracheostomy. 3 patients were under the tuberculostatic treatment and 5 patient begun the treatment with the acute episode. Several complications were noted, nosocomial pneumonia being most often (9 episodes in 4 patients, with Pseudomonas aeruginosa in 5 episodes). Two patients died, one with severe sepsis and one with acute myocardial infarction 3 days after weaning from MV. Time of weaning from MV was 3 - 9 days.
Conclusions: patients with severe respiratory failure caused by tuberculosis who need MV are in a poor condition, need a long term ventilatory strategy marked by a lot of complications. Their prognosis is linked with the success of the tuberculostatic treatment and seems to be more favorable than in other pulmonary pathology who needs MV.

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Citations should be made in the following way:
R. T. Stoica, A. Macri, A. Guse (Bucharest, Romania). Ventilatory support in severe pulmonary tuberculosis. Eur Respir J 2002; 20: Suppl. 38, 612

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