Introduction- Chronic Critical Illness (chronic CI) is a condition associated to patients surviving an episode of acute respiratory failure (ARF). The prevalence and the factors associated with the development of chronic CI in the population admitted to a Respiratory Intensive Care Unit (RICU) have not been yet elucidated. Methods- An observational prospective cohort study was undertaken at the RICU of the University Hospital of Modena (Italy). Patients mechanically ventilated with ARF in RICU were enrolled. Demographics, severity scores (APACHEII, SOFA, SAPSII), and clinical condition (septic shock, pneumonia, ARDS) were recorded on admission. Respiratory mechanics and inflammatory-metabolic blood parameters were measured both on admission and over the first week of stay. All variables were tested as predictors of chronic CI through univariate and multivariate analysis. Results- chronic CI occurred in 33 out of 100 patients observed. Higher APACHEII, the presence of septic shock, diaphragmatic dysfunction (DD) at sonography, multidrug-resistant (MDR) bacterial infection, the occurrence of a second infection during stay, and a C-reactive protein (CRP) serum level inceasing 7 days over admission were associated with chronic CI. Septic shock was the strongest predictor of chronic CI (AUC=0.92 p<0.0001). Conclusions- Chronic CI is frequent in patients admitted to RICU and mechanically ventilated due to ARF. Infection-related factors seem to play a major role as predictors of this syndrome.

Prevalence and development of chronic critical illness in acute patients admitted to a respiratory intensive care setting / Marchioni, Alessandro; Tonelli, Roberto; Sdanganelli, Antonia; Gozzi, Filippo; Musarò, Lorenzo; Fantini, Riccardo; Tabbì, Luca; Andreani, Alessandro; Cappiello, Gaia; Costi, Stefania; Castaniere, Ivana; Clini, Enrico. - In: PULMONOLOGY. - ISSN 2531-0429. - 26:(2020), pp. 1-8. [10.1016/j.pulmoe.2019.09.006]

Prevalence and development of chronic critical illness in acute patients admitted to a respiratory intensive care setting

Alessandro Marchioni;Roberto Tonelli
;
Filippo Gozzi;Stefania Costi;Ivana Castaniere;Enrico Clini
2020

Abstract

Introduction- Chronic Critical Illness (chronic CI) is a condition associated to patients surviving an episode of acute respiratory failure (ARF). The prevalence and the factors associated with the development of chronic CI in the population admitted to a Respiratory Intensive Care Unit (RICU) have not been yet elucidated. Methods- An observational prospective cohort study was undertaken at the RICU of the University Hospital of Modena (Italy). Patients mechanically ventilated with ARF in RICU were enrolled. Demographics, severity scores (APACHEII, SOFA, SAPSII), and clinical condition (septic shock, pneumonia, ARDS) were recorded on admission. Respiratory mechanics and inflammatory-metabolic blood parameters were measured both on admission and over the first week of stay. All variables were tested as predictors of chronic CI through univariate and multivariate analysis. Results- chronic CI occurred in 33 out of 100 patients observed. Higher APACHEII, the presence of septic shock, diaphragmatic dysfunction (DD) at sonography, multidrug-resistant (MDR) bacterial infection, the occurrence of a second infection during stay, and a C-reactive protein (CRP) serum level inceasing 7 days over admission were associated with chronic CI. Septic shock was the strongest predictor of chronic CI (AUC=0.92 p<0.0001). Conclusions- Chronic CI is frequent in patients admitted to RICU and mechanically ventilated due to ARF. Infection-related factors seem to play a major role as predictors of this syndrome.
28-ott-2019
26
1
8
Prevalence and development of chronic critical illness in acute patients admitted to a respiratory intensive care setting / Marchioni, Alessandro; Tonelli, Roberto; Sdanganelli, Antonia; Gozzi, Filippo; Musarò, Lorenzo; Fantini, Riccardo; Tabbì, Luca; Andreani, Alessandro; Cappiello, Gaia; Costi, Stefania; Castaniere, Ivana; Clini, Enrico. - In: PULMONOLOGY. - ISSN 2531-0429. - 26:(2020), pp. 1-8. [10.1016/j.pulmoe.2019.09.006]
Marchioni, Alessandro; Tonelli, Roberto; Sdanganelli, Antonia; Gozzi, Filippo; Musarò, Lorenzo; Fantini, Riccardo; Tabbì, Luca; Andreani, Alessandro; Cappiello, Gaia; Costi, Stefania; Castaniere, Ivana; Clini, Enrico
File in questo prodotto:
File Dimensione Formato  
Marchioni (Development of CCI in RICU- 2019).pdf

accesso aperto

Tipologia: Versione dell'editore (versione pubblicata)
Dimensione 596.26 kB
Formato Adobe PDF
596.26 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1182922
Citazioni
  • ???jsp.display-item.citation.pmc??? 6
  • Scopus 9
  • ???jsp.display-item.citation.isi??? 6
social impact