tailieunhanh - Báo cáo y học: "Clinical features of invasive bronchial-pulmonary aspergillosis in critically ill patients with chronic obstructive respiratory diseases: a prospective study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Clinical features of invasive bronchial-pulmonary aspergillosis in critically ill patients with chronic obstructive respiratory diseases: a prospective study. | He et al. Critical Care 2011 15 R5 http content 15 1 R5 KS CRITICAL CARE RESEARCH Open Access Clinical features of invasive bronchial-pulmonary aspergillosis in critically ill patients with chronic obstructive respiratory diseases a prospective study Hangyong HeH Lin Ding1 f Fang Li2 Qingyuan Zhan1 Abstract Introduction Critically ill patients with chronic obstructive respiratory diseases CORD who require intensive care unit ICU admission are at particular risk for invasive bronchial-pulmonary aspergillosis IBPA . The purpose of this study is to investigate clinical features for rapid recognition of IBPA in critically ill patients with CORD. Methods We included 55 consecutive CORD patients in a respiratory ICU in a prospective single-center cohort study. In this study IBPA combined two entities ATB and IPA. Results Thirteen of 55 patients were diagnosed with IBPA. Before ICU admission three variables were independent predictors of IBPA with statistical significance more than three kinds of antibiotics used before the ICU admission accumulated doses of corticosteroids 350 mg received before the ICU admission and APACHE II scores 18 OR P OR P and OR P respectively . After ICU admission more IBPA patients had a high fever C versus P wheeze without exertion versus P dry rales versus P higher white blood cell counts 21 X 109 L versus X 109 L P lower mean arterial pressures mm Hg versus mm Hg P and serum creatinine clearances ml min versus ml min P and liver-function and coagulation abnormalities. Bronchospasm sputum ropiness and plaque formation were more common for IBPA patients during bronchoscopy versus P 18 versus 0 P and 73 versus 13 P respectively . More IBPA patients had nodules and patchiness on chest radiograph on day 1 of admission which rapidly progressed to consolidation on day 7. IBPA .