Literature DB >> 11605892

The prognosis of respiratory failure in patients with tuberculous destroyed lung.

J H Park1, J O Na, E K Kim, C M Lim, T S Shim, S D Lee, W S Kim, D S Kim, W D Kim, Y Koh.   

Abstract

SETTING: The medical intensive care unit of a tertiary referral hospital.
OBJECTIVE: To determine the prognosis of patients whose lungs are damaged by previous and/or present tuberculosis infection and who have subsequently been presented with acute respiratory failure requiring mechanical ventilation.
DESIGN: A consecutive series of 38 patient cases with retrospective data analysis.
RESULTS: Pulmonary function test results for tests performed within the previous year were made available in 21 of the 38 cases (55%). These showed a mean (+/- SD) forced vital capacity (FVC) of 1.52 +/- 0.46 L (41.0 +/- 14.5% predicted), a forced expiratory volume/second (FEV1) of 0.77 +/- 0.18 L (29.3 +/- 13.6% predicted), and an FEV1/FVC ratio of 55.1 +/- 16.2%. The acid-fast bacilli (AFB) positive group had a significantly higher mortality and more severe lung destruction when compared with the AFB-negative group. Patients with positive AFB were significantly more hypocapnic than those with negative AFB (6.4 +/- 2.7 vs. 9.3 +/- 3.9 kPa, P = 0.020). In multivariate analysis, the level of PaCO2 on admission was identified as the only significant prognostic index (OR 0.76, 95%CI 0.60-0.96).
CONCLUSION: Patients with positive AFB smears or cultures may have higher mortality rates than those with negative AFB in the tuberculosis destroyed lung patients with acute respiratory failure. A higher PaCO2 measurement could indicate a better survival rate in this group of patients.

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Year:  2001        PMID: 11605892

Source DB:  PubMed          Journal:  Int J Tuberc Lung Dis        ISSN: 1027-3719            Impact factor:   2.373


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