title: [Clinical features and outcomes of mechanically ventilated patients with acute respiratory failure during treatment with immunosuppressive drugs].
abstract: We examined clinical features and outcomes of mechanically ventilated patient (n = 11) retrospectively who had developed acute respiratory failure during treatments with immunosuppressive drugs. The mean APACHE II score was 22.6, and the mean lung injury score was 2.9. In eight patients chest X-ray and computed tomography showed interstitial pneumonia. Fungus and/or cytomegalovirus were isolated most often from patients with interstitial pneumonia. Observed mortality (72.7%) was significantly (P < 0.001) higher than predicted mortality (45.1%) in the APACHE II score. Patients, who were complicated with septic shock caused by fungus infection, showed poor mortality. These results suggest that the fungus and cytomegalovirus infections might be associated with poor prognosis in patients with acute respiratory failure during treatment with immunosuppressive drugs.
authors.affiliation: Critical Care Medical Center, Asahikawa Red Cross Hospital.
authors.forename: N
authors.initials: N
authors.lastname: Tsujiguchi
authors.forename: N
authors.initials: N
authors.lastname: Fujimura
authors.forename: J
authors.initials: J
authors.lastname: Arakawa
authors.forename: M
authors.initials: M
authors.lastname: Kotaki
authors.forename: T
authors.initials: T
authors.lastname: Omote
authors.forename: A
authors.initials: A
authors.lastname: Namiki
mesh_terms: D000208:Acute Disease; D000328:Adult; D003587:Cytomegalovirus / Q000302:isolation & purification; D005260:Female; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D017563:Lung Diseases, Interstitial / Q000139:chemically induced / Q000382:microbiology; D008297:Male; D008775:Methylprednisolone / Q000009:adverse effects; D008875:Middle Aged; D011239:Prednisolone / Q000009:adverse effects; D011379:Prognosis; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000139:chemically induced* / Q000382:microbiology / Q000628:therapy*; D012189:Retrospective Studies
chemical_list: D007166:Immunosuppressive Agents; D011239:Prednisolone; D008775:Methylprednisolone