AIM:To identify risk factors predictive of intensive care unit(ICU) mortality in patients with ventilator-related pancreatitis.The clinical outcomes of patients with ventilator-related pancreatitis were compared with ...AIM:To identify risk factors predictive of intensive care unit(ICU) mortality in patients with ventilator-related pancreatitis.The clinical outcomes of patients with ventilator-related pancreatitis were compared with those of patients with pancreatitis-related respiratory failure as well as controls.METHODS:One hundred and forty-eight patients with respiratory failure requiring mechanical ventilation and concomitant acute pancreatitis were identified from a prospectively collected dataset of 9108 consecutive patients admitted with respiratory failure over a period of five years.Sixty patients met the criteria for ventilator-related pancreatitis,and 88(control patients),for pancreatitis-related respiratory failure.RESULTS:Mortality rate in ventilator-related pancreatitis was comparable to that in ICU patients without pancreatitis by case-control methodology(P=0.544).Multivariate logistic regression analysis identified low PaO2/FiO2(OR:1.032,95% CI:1.006-1.059,P=0.016) as an independent risk factor for mortality in patients with ventilator-related pancreatitis.The mortality rate in patients with ventilator-related pancreatitis was lower than that in patients with acute pancreatitis-related respiratory failure(P<0.001).CONCLUSION:We found that low PaO2/FiO2 was an independent clinical parameter predictive of ICU mortality in patients with ventilator-related pancreatitis.展开更多
Objective:This study summarizes and compares clinical and laboratory characteristics of 34 patients admitted to the intensive care unit(ICU)for complications from coronavirus disease 2019(COVID-19)at the First Affilia...Objective:This study summarizes and compares clinical and laboratory characteristics of 34 patients admitted to the intensive care unit(ICU)for complications from coronavirus disease 2019(COVID-19)at the First Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou,China from Jan.22 to Mar.5,2020.Methods:A total of 34 patients were divided into two groups,including those who required noninvasive ventilation(NIV)and invasive mechanical ventilation(IMV)with additional extracorporeal membrane oxygenation(ECMO)in 11 patients.Clinical features of COVID-19 patients were described and the parameters of clinical characteristics between the two groups were compared.Results:The rates of the acute cardiac and kidney complications were higher in IMV cases than those in NIV cases.Most patients had lymphocytopenia on admission,with lymphocyte levels dropping progressively on the following days,and the more severe lymphopenia developed in the IMV group.In both groups,T lymphocyte counts were below typical lower limit norms compared to B lymphocytes.On admission,both groups had higher than expected amounts of plasma interleukin-6(IL-6),which over time declined more in NIV patients.The prothrombin time was increased and the levels of platelet,hemoglobin,blood urea nitrogen(BUN),D-dimer,lactate dehydrogenase(LDH),and IL-6 were higher in IMV cases compared with NIV cases during hospitalization.Conclusions:Data showed that the rates of complications,dynamics of lymphocytopenia,and changes in levels of platelet,hemoglobin,BUN,D-dimer,LDH and IL-6,and prothrombin time in these ICU patients were significantly different between IMV and NIV cases.展开更多
文摘AIM:To identify risk factors predictive of intensive care unit(ICU) mortality in patients with ventilator-related pancreatitis.The clinical outcomes of patients with ventilator-related pancreatitis were compared with those of patients with pancreatitis-related respiratory failure as well as controls.METHODS:One hundred and forty-eight patients with respiratory failure requiring mechanical ventilation and concomitant acute pancreatitis were identified from a prospectively collected dataset of 9108 consecutive patients admitted with respiratory failure over a period of five years.Sixty patients met the criteria for ventilator-related pancreatitis,and 88(control patients),for pancreatitis-related respiratory failure.RESULTS:Mortality rate in ventilator-related pancreatitis was comparable to that in ICU patients without pancreatitis by case-control methodology(P=0.544).Multivariate logistic regression analysis identified low PaO2/FiO2(OR:1.032,95% CI:1.006-1.059,P=0.016) as an independent risk factor for mortality in patients with ventilator-related pancreatitis.The mortality rate in patients with ventilator-related pancreatitis was lower than that in patients with acute pancreatitis-related respiratory failure(P<0.001).CONCLUSION:We found that low PaO2/FiO2 was an independent clinical parameter predictive of ICU mortality in patients with ventilator-related pancreatitis.
基金the Project for Emergency of Key R&D Plan from Zhejiang Science and Technology Agency(No.2020C03123),China。
文摘Objective:This study summarizes and compares clinical and laboratory characteristics of 34 patients admitted to the intensive care unit(ICU)for complications from coronavirus disease 2019(COVID-19)at the First Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou,China from Jan.22 to Mar.5,2020.Methods:A total of 34 patients were divided into two groups,including those who required noninvasive ventilation(NIV)and invasive mechanical ventilation(IMV)with additional extracorporeal membrane oxygenation(ECMO)in 11 patients.Clinical features of COVID-19 patients were described and the parameters of clinical characteristics between the two groups were compared.Results:The rates of the acute cardiac and kidney complications were higher in IMV cases than those in NIV cases.Most patients had lymphocytopenia on admission,with lymphocyte levels dropping progressively on the following days,and the more severe lymphopenia developed in the IMV group.In both groups,T lymphocyte counts were below typical lower limit norms compared to B lymphocytes.On admission,both groups had higher than expected amounts of plasma interleukin-6(IL-6),which over time declined more in NIV patients.The prothrombin time was increased and the levels of platelet,hemoglobin,blood urea nitrogen(BUN),D-dimer,lactate dehydrogenase(LDH),and IL-6 were higher in IMV cases compared with NIV cases during hospitalization.Conclusions:Data showed that the rates of complications,dynamics of lymphocytopenia,and changes in levels of platelet,hemoglobin,BUN,D-dimer,LDH and IL-6,and prothrombin time in these ICU patients were significantly different between IMV and NIV cases.
