RT Journal Article
SR Electronic
T1 Acute respiratory failure in progressive neurological diseases: What is important for intensive care unit and long-term survival?
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA3563
DO 10.1183/13993003.congress-2016.PA3563
VO 48
IS suppl 60
A1 Ülgen Yalaz Tekan
A1 Emine Aksoy
A1 Feyza Kargin
A1 Rabia Sari
A1 Cüneyt Saltürk
A1 Fulya Çiyiltepe
A1 Dilek Yavuz
A1 Gökay Güngör
A1 Nalan Adigüzel
A1 Zuhal Karakurt
YR 2016
UL http://erj.ersjournals.com/content/48/suppl_60/PA3563.abstract
AB 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.