Critically Ill Patients with Interstitial Lung Disease

Hadley, Ryan; Hyzy, Robert C.

doi:10.1016/j.ccm.2015.05.012

Cited by 5 publications

(7 citation statements)

References 82 publications

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“…Although, the outcomes of our patients seemed slightly worse than those of CTD-ILD patients as reported by Gannon [11], they may be somewhat better than those reported previously in critically ill ILD patients [8,33,34]. Moreover, our cohort was larger, included a different case mix, and was characterized by a higher illness severity (SAPS II at 43 [32; 59] and SOFA at 7 [4][5][6][7][8][9]). It is well known that high SAPS II and/or SOFA score and the need for life-sustaining therapies such as vasoactive drugs and invasive ventilation are associated with poor outcomes in critically ill patients [26,28,35].…”

Section: Discussioncontrasting

confidence: 56%

“…Among the SRD-ILD patients, 28 died in the ICU, corresponding to a mortality rate of 40%. The median ICU length-of-stay was 7 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) days. Six additional patients died before hospital discharge, bringing the in-hospital mortality rate to 49% (Table 1 and Figures 1 and 2).…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, Mallick et al reviewed the data of patients with idiopathic pulmonary fibrosis who were mechanically ventilated and found an inhospital mortality of 87% and a three-month mortality of 94% [34]. However, data from the poor outcomes associated with patients with interstitial pulmonary fibrosis requiring invasive ventilation are often assigned confusedly to all patients with ILD [6,9]. Recently, Gannon et al [11] reported the results of a large cohort of 126 critically ill ILD patients and found that a diagnosis of CTD-ILD was independently associated with a substantially lower risk of short-and long-term death compared to other ILDs.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, in a recent review, Huapaya et al reported a high in-hospital mortality rate at 52% [7]. The outcome seems mainly linked to illness severity, need for mechanical ventilation [5,7], and high-resolution computed tomography (HRCT) patterns, such as fibrosis [8,9] and usual interstitial pneumonia (UIP) [10]. However, the prognosis is also linked to the underlying etiology [11].…”

Section: Introductionmentioning

confidence: 99%

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Interstitial Lung Disease Worsens Short- and Long-Term Outcomes of Systemic Rheumatic Disease Patients Admitted to the ICU: A Multicenter Study

Banuls

Vanoverschelde

Garnier

et al. 2021

JCM

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Critically ill patients with systemic rheumatic diseases (SRDs) have a fair prognosis, while those with interstitial lung disease (ILD) have a poorer outcome. However, the prognosis of SRD patients with ILD admitted to the intensive care unit (ICU) remains unclear. We conducted a case–control study to investigate the outcomes of critically ill SRD-ILD patients. Consecutive SRD-ILD patients admitted to five ICUs from January 2007 to December 2017 were compared to SRD patients without ILD. Mortality rates were compared between groups, and prognostic factors were then identified. One hundred and forty critically ill SRD patients were included in the study. Among the 70 patients with SRD–ILD, the SRDs were connective tissue diseases (56%), vasculitis (29%), sarcoidosis (13%), and spondylarthritis (3%). Patients were mainly admitted for acute exacerbation of SRD-ILD (36%) or infection (34%). ICU, in-hospital, and one-year mortality rates in SRD-ILD patients were higher than in SRD patients without ILD (n = 70): 40% vs. 16% (p < 0.01), 49% vs. 19% (p < 0.01), and 66% vs. 40% (p < 0.01), respectively. Hypoxemia, high sequential organ failure assessment (SOFA) score, and admission for ILD acute exacerbation were associated with ICU mortality. In conclusion, ILD worsened the outcomes of SRD patients admitted to the ICU. Admissions related to SRD-ILD acute exacerbation and the severity of the acute respiratory failure were associated with ICU mortality.

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Interstitial Lung Disease Worsens Short- and Long-Term Outcomes of Systemic Rheumatic Disease Patients Admitted to the ICU: A Multicenter Study

Banuls

Vanoverschelde

Garnier

et al. 2021

JCM

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“…73,74 Once respiratory failure requiring noninvasive ventilation or mechanical ventilation occurs, short-term mortality becomes even higher. 76 Other factors associated with increased mortality include male sex, increased age, precapillary pulmonary hypertension, and right-heart failure. 74,77 Specific underlying diagnoses, such as idiopathic pulmonary fibrosis and connective tissue disease-related paren-chymal lung disease, also portend a worse prognosis.…”

Section: Identification Of Patients In Respiratory Compromise Due To mentioning

confidence: 99%

Respiratory Compromise as a New Paradigm for the Care of Vulnerable Hospitalized Patients

et al. 2017

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Acute respiratory compromise describes a deterioration in respiratory function with a high likelihood of rapid progression to respiratory failure and death. Identifying patients at risk for respiratory compromise coupled with monitoring of patients who have developed respiratory compromise might allow earlier interventions to prevent or mitigate further decompensation. The National Association for the Medical Direction of Respiratory Care (NAMDRC) organized a workshop meeting with representation from many national societies to address the unmet needs of respiratory compromise from a clinical practice perspective. Respiratory compromise may arise de novo or may complicate preexisting lung disease. The group identified distinct subsets of respiratory compromise that present similar opportunities for early detection and useful intervention to prevent respiratory failure. The subtypes were characterized by the pathophysiological mechanisms they had in common: impaired control of breathing, impaired airway protection, parenchymal lung disease, increased airway resistance, hydrostatic pulmonary edema, and right-ventricular failure. Classification of acutely ill respiratory patients into one or more of these categories may help in selecting the screening and monitoring strategies that are most appropriate for the patient's particular pathophysiology. Standardized screening and monitoring practices for patients with similar mechanisms of deterioration may enhance the ability to predict respiratory failure early and prevent its occurrence.

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Palliative Care for the Interstitial Lung Disease Patient a Must and Not Just a Need

Chaaban

McCormick

Gleason

et al. 2021

Am J Hosp Palliat Care

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Patients with interstitial lung disease (ILD) have many unmet palliative care needs. The majority of patients with chronic ILD have poor access to a specialist in palliative medicine and that is due to several barriers. The mortality for the ILD patient is high and reaches up to 80% if admitted to the ICU with respiratory failure. Palliative care addresses symptoms in diseases where cure is unlikely or impossible. Palliative care consultation also ensures communication among patients, caregivers and providers regarding treatments, prognosis, and end of life planning. Methods: We performed a literature review on palliative care and ILD, accessing articles published since 2002. We found 71 articles related to the topic. We chose 37 that were most relevant and with no redundancy of information to include in this review. Objectives: Summarize the palliative care needs of patients with ILD, discuss the barriers to receiving palliative care, and summarize clinical practice for providing palliative care to this patient population.

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Critically Ill Patients with Interstitial Lung Disease

Cited by 5 publications

References 82 publications

Interstitial Lung Disease Worsens Short- and Long-Term Outcomes of Systemic Rheumatic Disease Patients Admitted to the ICU: A Multicenter Study

Interstitial Lung Disease Worsens Short- and Long-Term Outcomes of Systemic Rheumatic Disease Patients Admitted to the ICU: A Multicenter Study

Respiratory Compromise as a New Paradigm for the Care of Vulnerable Hospitalized Patients

Palliative Care for the Interstitial Lung Disease Patient a Must and Not Just a Need

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