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Free Content The prognosis of respiratory failure in patients with tuberculous destroyed lung

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SETTING: 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.

DESIGN: 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).

CONCLUSION: 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.

Keywords: destroyed lung; predictors; respiratory failure; tuberculosis

Document Type: Regular Paper

Affiliations: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Korea

Publication date: October 1, 2001

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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