Untitled

Semple, David; Keogh, J. A. B.; Forni, Luigi; Venn, Richard

doi:10.1186/cc2937

Cited by 35 publications

(18 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These treatments should be tailored to disease severity, to the nature and extent of organ dysfunction in each individual patient [4,9-11,15,52,54]. Although no data from controlled, randomized, clinical trials are available, guidelines have been developed [52].…”

Section: Reviewmentioning

confidence: 99%

Vasculitic emergencies in the intensive care unit: a special focus on cryoglobulinemic vasculitis

Zaidan

Mariotte

Galicier

et al. 2012

Ann. Intensive Care

View full text Add to dashboard Cite

Vasculitis is characterized by the infiltration of vessel walls by inflammatory leukocytes with reactive damage and subsequent loss of vessel integrity. The clinical course of systemic vasculitis may be punctuated by acute life-threatening manifestations that require intensive care unit (ICU) admission. Furthermore, the diagnosis may be established in the ICU after admission for a severe inaugural symptom, mostly acute respiratory failure. Among the systemic vasculitides, cryoglobulinemic vasculitis (CV) has been rarely studied in an ICU setting. Severe CV-related complications may involve the kidneys, lungs, heart, gut, and/or central nervous system. The diagnosis of CV in the ICU may be delayed or completely unrecognized. A high level of suspicion is critical to obtain a timely and accurate diagnosis and to initiate appropriate treatment. We describe severe acute manifestations of CV based on six selected patients admitted to our ICU. That all six patients survived suggests the benefit of prompt ICU admission of patients with severe CV.

show abstract

Section: Reviewmentioning

confidence: 99%

Vasculitic emergencies in the intensive care unit: a special focus on cryoglobulinemic vasculitis

Zaidan

Mariotte

Galicier

et al. 2012

Ann. Intensive Care

View full text Add to dashboard Cite

show abstract

“…With the development of therapeutic strategies that include corticosteroids, immunosuppressants, and (plasma exchange [PLEX]), SVV survival rates have considerably improved, from 30 to 75 % at 5 years [ 3 ]. The leading causes of death are related mainly to a life-threatening disease at the time of diagnosis or long-term complications of immunosuppressive therapies, all of which may require intensive care unit (ICU) admission [ 4 , 5 ]. To date, there are only few studies, all retrospective, in which researchers have reported the outcomes of patients with vasculitis admitted to the ICU.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of patients admitted to intensive care units for acute manifestation of small-vessel vasculitis: a multicenter, retrospective study

Kimmoun¹,

Baux²,

Das³

et al. 2016

Crit Care

View full text Add to dashboard Cite

BackgroundThe outcomes of patients admitted to the intensive care unit (ICU) for acute manifestation of small-vessel vasculitis are poorly reported. The aim of the present study was to determine the mortality rate and prognostic factors of patients admitted to the ICU for acute small-vessel vasculitis.MethodsThis retrospective, multicenter study was conducted from January 2001 to December 2014 in 20 ICUs in France. Patients were identified from computerized registers of each hospital using the International Classification of Diseases, Ninth Revision (ICD-9). Inclusion criteria were (1) known or highly suspected granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis, microscopic polyangiitis (respectively, ICD-9 codes M31.3, M30.1, and M31.7), or anti–glomerular basement membrane antibody disease (ICD-9 codes N08.5X-005 or M31.0+); (2) admission to the ICU for the management of an acute manifestation of vasculitis; and (3) administration of a cyclophosphamide pulse in the ICU or within 48 h before admission to the ICU. The primary endpoint was assessment of mortality rate 90 days after admission to the ICU.ResultsEighty-two patients at 20 centers were included, 94 % of whom had a recent (<6 months) diagnosis of small-vessel vasculitis. Forty-four patients (54 %) had granulomatosis with polyangiitis. The main reasons for admission were respiratory failure (34 %) and pulmonary-renal syndrome (33 %). Mechanical ventilation was required in 51 % of patients, catecholamines in 31 %, and renal replacement therapy in 71 %. Overall mortality at 90 days was 18 % and the mortality in ICU was 16 %. The main causes of death in the ICU were disease flare in 69 % and infection in 31 %. In univariable analysis, relevant factors associated with death in nonsurvivors compared with survivors were Simplified Acute Physiology Score II (median [interquartile range] 51 [38–82] vs. 36 [27–42], p = 0.005), age (67 years [62–74] vs. 58 years [40–68], p < 0.003), Sequential Organ Failure Assessment score on the day of cyclophosphamide administration (11 [6–12] vs. 6 [3–7], p = 0.0004), and delayed administration of cyclophosphamide (5 days [3–14] vs. 2 days [1–5], p = 0.0053).ConclusionsPatients admitted to the ICU for management of acute small-vessel vasculitis benefit from early, aggressive intensive care treatment, associated with an 18 % death rate at 90 days.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-016-1189-5) contains supplementary material, which is available to authorized users.

show abstract

“…They reported a lower in-ICU mortality varying from 11% to 33%. However, a higher mortality rate may occur in case of pulmonary determinations reaching more than 50% [ 15 ]. Prognostic systems developed to predict outcomes in critical illness [ 16 , 17 ] were evaluated in such patients as well as the level of vasculitis disease activity.…”

Section: Introductionmentioning

confidence: 99%

Prognosis and ICU outcome of systemic vasculitis

et al. 2013

View full text Add to dashboard Cite

BackgroundSystemic vasculitis may cause life threatening complications requiring admission to an intensive care unit (ICU). The aim of this study was to evaluate outcomes of systemic vasculitis patients admitted to the ICU and to identify prognosis factors.MethodsDuring a ten-year period, records of 31 adult patients with systemic vasculitis admitted to ICUs (median age: 63 y.o, sex ratio M/F: 21/10, SAPS II: 40) were reviewed including clinical and biological parameters, use of mechanical ventilation, catecholamine or/and dialysis support. Mortality was assessed and data were analyzed to identify predictive factors of outcome.ResultsCauses of ICU admissions were active manifestation of vasculitis (n = 19), septic shock (n = 8) and miscellaneous (n = 4). Sixteen patients (52%) died in ICU. By univariate analysis, mortality was associated with higher SOFA (p = 0.006) and SAPS II (p = 0.004) scores. The need for a catecholamine support or/and a renal replacement therapy, and the occurrence of an ARDS significantly worsen the prognosis. By multivariate analysis, only SAPS II (Odd ratio: 1.16, 95% CI [1.01; 1.33]) and BVAS scores (Odd ratio: 1.16, 95% CI = [1.01; 1.34]) were predictive of mortality.ConclusionThe mortality rate of severe vasculitis requiring an admission to ICU was high. High levels of SAPS II and BVAS scores at admission were predictive of mortality.

show abstract

Untitled

Cited by 35 publications

References 37 publications

Vasculitic emergencies in the intensive care unit: a special focus on cryoglobulinemic vasculitis

Vasculitic emergencies in the intensive care unit: a special focus on cryoglobulinemic vasculitis

Outcomes of patients admitted to intensive care units for acute manifestation of small-vessel vasculitis: a multicenter, retrospective study

Prognosis and ICU outcome of systemic vasculitis

Contact Info

Product

Resources

About