Acute exacerbation of COPD requiring admission to the intensive care unit.
OBJECTIVE
The aim of this study was to summarize experiences of patients admitted to the intensive care unit (ICU) for an acute exacerbation of COPD and to identify factors associated with a poor outcome.


METHODS
An observational case series of 102 consecutive admissions to the ICU for acute exacerbation of COPD between January 1998 and December 2002 were studied.


RESULTS
In total, 102 admissions to the ICU were reviewed. There were no ICU deaths but there were 18 hospital deaths (18%). A total of 28 patients were treated with non-invasive positive pressure ventilation (NIPPV), of whom four (14% failure rate) subsequently required intubation and mechanical ventilation (MV). Another 16 patients (16%) were successfully weaned from MV with NIPPV. Nine patients (9%), who had more than one episode of re-intubation after weaning (RAW), were from the mechanically ventilated group. Tracheostomy was performed for four patients (3.9%). The median duration of both NIPPV and MV was 1 day. The median length of stay in the ICU and hospital were 2 days (SD, 7.2) and 8 days (SD, 9.6), respectively. Univariate analysis identified serum total protein to be associated with hospital mortality (P = 0.004)


CONCLUSIONS
For patients with acute exacerbations of COPD in the ICU, serum total protein, a surrogate marker for nutrition, was significantly associated with hospital mortality.
Yang
Steve
S
Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore. gm3yty@sgh.com.sg
Tan
Keng-Leong
KL
Devanand
Anantham
A
Fook-Chong
Stephanie
S
Eng
Philip
P
D000368:Aged; D001798:Blood Proteins / Q000032:analysis; D003422:Critical Care / Q000706:statistics & numerical data*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D010343:Patient Admission / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000401:mortality / Q000628:therapy*; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology
D001798:Blood Proteins