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Acute respiratory failure in progressive neurological diseases: What is important for intensive care unit and long-term survival?

Ülgen Yalaz Tekan, Emine Aksoy, Feyza Kargin, Rabia Sari, Cüneyt Saltürk, Fulya Çiyiltepe, Dilek Yavuz, Gökay Güngör, Nalan Adigüzel, Zuhal Karakurt
European Respiratory Journal 2016 48: PA3563; DOI: 10.1183/13993003.congress-2016.PA3563
Ülgen Yalaz Tekan
1Clinic of Anesthesiology and Reanimation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
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Emine Aksoy
2Respiratory Intensive Care Unit, Süreyyapasa Chest Disease and Chest Surgery Training and Research Hospital, Istanbul, Turkey
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Feyza Kargin
2Respiratory Intensive Care Unit, Süreyyapasa Chest Disease and Chest Surgery Training and Research Hospital, Istanbul, Turkey
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Rabia Sari
1Clinic of Anesthesiology and Reanimation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
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Cüneyt Saltürk
2Respiratory Intensive Care Unit, Süreyyapasa Chest Disease and Chest Surgery Training and Research Hospital, Istanbul, Turkey
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Fulya Çiyiltepe
1Clinic of Anesthesiology and Reanimation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
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Dilek Yavuz
2Respiratory Intensive Care Unit, Süreyyapasa Chest Disease and Chest Surgery Training and Research Hospital, Istanbul, Turkey
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Gökay Güngör
2Respiratory Intensive Care Unit, Süreyyapasa Chest Disease and Chest Surgery Training and Research Hospital, Istanbul, Turkey
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Nalan Adigüzel
2Respiratory Intensive Care Unit, Süreyyapasa Chest Disease and Chest Surgery Training and Research Hospital, Istanbul, Turkey
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Zuhal Karakurt
2Respiratory Intensive Care Unit, Süreyyapasa Chest Disease and Chest Surgery Training and Research Hospital, Istanbul, Turkey
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Abstract

Objective: Respiratory complications are frequently observed in chronic neurological diseases because of loss of the airway protective reflexes and respiratory muscle weakness. In this study, we investigated the survival of this patient group in the intensive care unit (ICU) and after discharge.

Method: A retrospective cohort study was conducted in a level III respiratory ICU of a tertiary hospital for chest diseases between January 1st, 2010 and June 15th, 2015. Patiens that have acute respiratory failure due to neurological dysfunction were included into the study. Results were analyzed with descriptive statistics and Kaplan-Meier survival analyses were performed.

Results: 220 patients (65.5% male) whose median (interquartile ratio, IQR) age was 76 (16-93) were included into the study. The most frequent neurological diagnosis were dementia (37.3%), cerebrovascular disease (22.7%), motor neuron disease (14.1%) and myopathy (6.8%). 45% of patients had hypoxemic respiratory failure while 45.9% had both hypoxemia and hypercapnia. 86.8% of patients were diagnosed with pneumonia, while 34.5% had septic shock within 24 hours of admission. ICU mortality rate was 33.6% (n=74). Four years follow-up, the patients who use longterm noninvazive mechanical ventilation survived significantly longer (kaplan meier p: 0.004). According to cox regression hazard analysis, it was found that male gender, hypoxemy, septic shock and requirement of nasogastric tube feeding increased risk for mortality.

Conclusion: Long-term mechanical ventilation support may contribute to better survival of patients who suffer from respiratory complications of progressive neurological diseases.

  • Chronic disease
  • Non-invasive ventilation - long-term
  • Copyright ©the authors 2016
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Acute respiratory failure in progressive neurological diseases: What is important for intensive care unit and long-term survival?
Ülgen Yalaz Tekan, Emine Aksoy, Feyza Kargin, Rabia Sari, Cüneyt Saltürk, Fulya Çiyiltepe, Dilek Yavuz, Gökay Güngör, Nalan Adigüzel, Zuhal Karakurt
European Respiratory Journal Sep 2016, 48 (suppl 60) PA3563; DOI: 10.1183/13993003.congress-2016.PA3563

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Acute respiratory failure in progressive neurological diseases: What is important for intensive care unit and long-term survival?
Ülgen Yalaz Tekan, Emine Aksoy, Feyza Kargin, Rabia Sari, Cüneyt Saltürk, Fulya Çiyiltepe, Dilek Yavuz, Gökay Güngör, Nalan Adigüzel, Zuhal Karakurt
European Respiratory Journal Sep 2016, 48 (suppl 60) PA3563; DOI: 10.1183/13993003.congress-2016.PA3563
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