Outcome of patients with cystic fibrosis admitted to the intensive care unit: Is invasive mechanical ventilation a risk factor for death in patients waiting lung transplantation?

Efrati, Ori; Bylin, Irena; Segal, Eran; Vilozni, Daphna; Modan-Moses, Dalit; Vardi, Amir; Szeinberg, Amir; Paret, Gideon

doi:10.1016/j.hrtlng.2009.06.014

« Previous Next »Heart & Lung: The Journal of Acute and Critical Care
Volume 39, Issue 2 , Pages 153-159, March 2010

Outcome of patients with cystic fibrosis admitted to the intensive care unit: Is invasive mechanical ventilation a risk factor for death in patients waiting lung transplantation?

Ori Efrati, MD
- Pediatric Pulmonology Unit, The Edmond and Lili Safra Children's Hospital, Sheba Medical Center Ramat-Gan, Israel
- Reprint requests: Ori Efrati, MD, Pediatric Pulmonology Unit, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel.
Irena Bylin, MD
- Pediatric Pulmonology Unit, The Edmond and Lili Safra Children's Hospital, Sheba Medical Center Ramat-Gan, Israel
Eran Segal, MD
- Intensive Care Unit, Sheba Medical Center, Ramat-Gan, Israel
Daphna Vilozni, PhD
- Pediatric Pulmonology Unit, The Edmond and Lili Safra Children's Hospital, Sheba Medical Center Ramat-Gan, Israel
Dalit Modan-Moses, MD
- Pediatric Pulmonology Unit, The Edmond and Lili Safra Children's Hospital, Sheba Medical Center Ramat-Gan, Israel
Amir Vardi, MD
- Pediatric Intensive Care Unit, The Edmond and Lili Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, Israel
Amir Szeinberg, MD
- Pediatric Pulmonology Unit, The Edmond and Lili Safra Children's Hospital, Sheba Medical Center Ramat-Gan, Israel
Gideon Paret, MD
- Pediatric Intensive Care Unit, The Edmond and Lili Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, Israel

published online 26 August 2009.

Objective

The admission of patients with cystic fibrosis (CF) to the intensive care unit (ICU) is controversial. Our aim was to study the long-term outcome of patients with CF who were admitted to the ICU and the effect of ventilation modality.

Methods

The medical records of 104 admissions (1996-2006) of 48 patients with CF (age 18±9 years) were reviewed. Seventeen patients were admitted with reversible conditions (group 1). Thirty-one patients were admitted for acute on chronic respiratory failure (group 2).

Results

In group 1, 16 of 17 patients survived up to 10 years from ICU admission. Conversely, in group 2, 23 of 31 patients (74%) died of respiratory failure. In group 2, 17 of 18 patients who were mechanically ventilated died within 90 days from admission, and 7 of 10 patients treated for prolonged periods with bi-level positive airway pressure are still alive up to 10 years after admission and transplantation.

Conclusion

Patients requiring mechanical ventilation may have a poor prognosis. The outcome of treatment with bi-level positive airway pressure is good, even in patients who had many episodes of acute respiratory failure.