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  • Vzroki življenje ogrožajočega poslabšanja astme pri bolnikih, zdravljenih v enoti intenzivne terapije Bolnišnice Topolšica = The precipitating factors of severe life threatening asthma exacerbation - experience of intensive care unit in Hospital Topolšica
    Drnovšek-Kaljanac, Majda ; Koren, Igor, dr. med.
    Background. The asthma exacerbation is especially in women in some countries still an important cause of death. In a five years long retrospective design we tried to identify the precipitating ... factors of severe life threatening asthma exacerbation of patients, treated in intensive care unit (ICU) of the pulmonary department in hospital Topolšica. Methods. We reevaluated the data of 46 patients treated for life threatening asthma exacerbation (LTAE), admitted to ICU from January 1994 to December 1998. The authors focused primarily on arterial blood gas analysis at admission as an indicator for further mechanical ventilation (MV), the difference in arterial blood gas analysis between mechanical ventilated and non ventilated group of patients, the use of pre-admitted therapy and of precipitating factors for asthma deterioration. Results. There were 36 women (78%), 73.0 +- 5.5 years old, and 10 men (22%), 54.0 +- 13.5 years old. Women to men ratio was 3.6 : 1. The average APACHE II at admission was 14.9 +- 5.8 and the mean stay in ICU was 5.7 +- 6.7 days. The preadmission regiment was as follows: inhaled B2 agonists87%, metlyxsanthines 80%, inhaled corticosteroids 59%, systemic corticosteroids 48%, other therapies 13%. 12 patients (26%) were on MV for 7.8+- 7.7 days. The mean pH of the arterial blood gas sample in MV group was 7.2 +- 0.31, compared to non MV group 7.4 +- 0.12 (p<0.05). The mean pCO2 of MV group was 10.3 +- 2.8 kPa, and of non-MV group 5.6 +- 1.7 kPa (p<0.001). Peak expiratory flow rate (PEFR) at discharge increased 2.15 +- 0.79 folds. 3 patients died (6.5%), all of cardiac complication. The precipitating factors that started LTAE were: respiratory tract infections 48%, arrythmias 22%, undertreated asthma 13% heart failure 11%, unidentified factors 11%, pulmonaryembolisms 6.5%, pneumothorax 2% and epilepsy 2%. (Abstract truncated at 2000 characters).
    Vir: Zdravniški vestnik : glasilo Slovenskega zdravniškega društva = Slovenian medical journal = journal of Slovenian Medical Association. - ISSN 1318-0347 (Letn. 70, št. 1, jan. 2001, str. 1-5)
    Vrsta gradiva - članek, sestavni del
    Leto - 2001
    Jezik - slovenski
    COBISS.SI-ID - 12788185

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