The prognosis of respiratory failure in patients with tuberculous destroyed lung.
METHODS
The medical intensive care unit of a tertiary referral hospital.


OBJECTIVE
To determine the prognosis of patients whose lungs are damaged by previous and/or present tuberculosis infection and who have subsequently been presented with acute respiratory failure requiring mechanical ventilation.


METHODS
A consecutive series of 38 patient cases with retrospective data analysis.


RESULTS
Pulmonary function test results for tests performed within the previous year were made available in 21 of the 38 cases (55%). These showed a mean (+/- SD) forced vital capacity (FVC) of 1.52 +/- 0.46 L (41.0 +/- 14.5% predicted), a forced expiratory volume/second (FEV1) of 0.77 +/- 0.18 L (29.3 +/- 13.6% predicted), and an FEV1/FVC ratio of 55.1 +/- 16.2%. The acid-fast bacilli (AFB) positive group had a significantly higher mortality and more severe lung destruction when compared with the AFB-negative group. Patients with positive AFB were significantly more hypocapnic than those with negative AFB (6.4 +/- 2.7 vs. 9.3 +/- 3.9 kPa, P = 0.020). In multivariate analysis, the level of PaCO2 on admission was identified as the only significant prognostic index (OR 0.76, 95%CI 0.60-0.96).


CONCLUSIONS
Patients with positive AFB smears or cultures may have higher mortality rates than those with negative AFB in the tuberculosis destroyed lung patients with acute respiratory failure. A higher PaCO2 measurement could indicate a better survival rate in this group of patients.
Park
J H
JH
Department of Internal Medicine, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Korea.
Na
J O
JO
Kim
E K
EK
Lim
C M
CM
Shim
T S
TS
Lee
S D
SD
Kim
W S
WS
Kim
D S
DS
Kim
W D
WD
Koh
Y
Y
D000328:Adult; D000368:Aged; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use; D001249:Asthma / Q000150:complications / Q000175:diagnosis; D015992:Body Mass Index; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis; D012129:Respiratory Function Tests; D012131:Respiratory Insufficiency / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013183:Sputum / Q000382:microbiology; D016019:Survival Analysis; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000175:diagnosis*; D014797:Vital Capacity / Q000502:physiology
D000904:Antibiotics, Antitubercular