Pulmonary tuberculosis in intensive care setting, with a focus on the use of severity scores, a multinational collaborative systematic review

Galvin, Jessica; Tiberi, Simon; Akkerman, Onno W.; Kerstjens, H.A.M.; Kunst, Heinke; Kurhasani, Xhevat; Ambrosino, Nicolino; Migliori, Giovanni Battista

doi:10.1016/j.pulmoe.2022.01.016

Cited by 17 publications

(18 citation statements)

References 53 publications

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“…A recent review has reported that the incidence of hospital-acquired infections was a negative predictor of mortality. However, we found that that hospital-acquired infections and shock are dependent variables contributing to mortality based on meta-regression analysis (34).…”

Section: Discussionmentioning

confidence: 99%

Factors Affecting Mortality in Critically Ill Patients With Tuberculosis: A Systematic Review and Meta-Analysis

Mishra,

Gala,

Chacko

2024

Critical Care Medicine

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Objectives: Critically ill patients with tuberculosis carry high mortality. Identification of factors associated with mortality in critically ill tuberculosis patients may enable focused treatment. Data Sources: An extensive literature search of PubMed (MEDLINE), Embase, the Cochrane Library, and Google Scholar was performed using Medical Subject Headings terms “tuberculosis,” “critical care,” “critical care outcome,” and “ICU.” We aimed to identify factors affecting mortality in critically ill tuberculosis patients. Study Selection: All the studies comparing factors affecting mortality between survivors and nonsurvivors in critically ill tuberculosis patients were included. The database search yielded a total of 3017 records, of which 17 studies were included in the meta-analysis. Data Extraction: Data were collected including the name of the author, year and country of publication, duration of the study, number of patients studied, type of tuberculosis, patient demography, smoking history, laboratory parameters, comorbidities, the requirement for mechanical ventilation, duration of ventilation, ICU and hospital length of stay (LOS), type of lung involvement, complications, and outcomes. Data Synthesis: The major factors that contributed to mortality in critically ill tuberculosis patients were age, platelet count, albumin, C-reactive protein (CRP), the requirement and duration of invasive mechanical ventilation, Pao 2/Fio 2 ratio, presence of acute respiratory distress syndrome, shock, hospital-acquired infections, renal replacement therapy, and ICU and hospital LOS. Conclusions: Patient age, platelet count, albumin and CRP levels, the requirement and duration of invasive mechanical ventilation, Pao 2/Fio 2 ratio, hospital-acquired infections, renal replacement therapy, and ICU LOS were variables associated with mortality.

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Section: Discussionmentioning

confidence: 99%

Factors Affecting Mortality in Critically Ill Patients With Tuberculosis: A Systematic Review and Meta-Analysis

Mishra,

Gala,

Chacko

2024

Critical Care Medicine

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“…Previous studies on pulmonary TB in the ICU setting reported hospital mortality of 52.9%. Attributable factors include delay in diagnosis and ATT initiation, altered drug absorption in critically ill patients, comorbidities like HIV and TB related complications [21] . In TB/HIV co-infected patients, ICU related complications were also common, with nosocomial pneumonia in 67.2% patients, pneumothorax in 13.8%, ARDS in 12.1%, acute renal failure in 12.1% and multi-organ failure (MOF) in 3.4% [22] .…”

Section: Discussionmentioning

confidence: 99%

Pulmonary tuberculosis complicated by pneumothorax, and acute respiratory distress syndrome (ARDS) in the settings of advanced HIV disease: A case report

Haile,

Tema,

Anjulo

et al. 2023

Journal of Clinical Tuberculosis and Other Mycobacterial Diseas

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“…Suboptimal concentrations of some drugs lead to recommend the intravenous use of specific treatments that are not always available in all countries. The presence of MDR-TB should be considered if the patient comes from high-risk regions, has been previously treated with first-line drugs or has failed to respond to standard treatment [ 123 ].…”

Section: Is Tuberculosis a Concern In Intensive Care Units?mentioning

confidence: 99%

Tuberculosis in Spain: An opinion paper

Moreno Guillén,

Rodríguez-Artalejo,

Ruiz-Galiana

et al. 2023

Rev Esp Quimioter

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This document is the result of the deliberations of the Committee on Emerging Pathogens and COVID-19 of the Illustrious Official College of Physicians of Madrid (ICOMEM) regarding the current situation of tuberculosis, particularly in Spain. We have reviewed aspects such as the evolution of its incidence, the populations currently most exposed and the health care circuits for the care of these patients in Spain. We have also discussed latent tuberculosis, the reality of extrapulmonary disease in the XXI century and the means available in daily practice for the diagnosis of both latent and active forms. The contribution of molecular biology, which has changed the perspective of this disease, was another topic of discussion. The paper tries to put into perspective both the classical drugs and their resistance figures and the availability and indications of the new ones. In addition, the reality of direct observation in the administration of antituberculosis drugs has been discussed. All this revolution is making it possible to shorten the treatment time for tuberculosis, a subject that has also been reviewed. If everything is done well, the risk of relapse of tuberculosis is small but it exists. On the other hand, many special situations have been discussed in this paper, such as tuberculosis in pediatric age and tuberculosis as a cause for concern in surgery and intensive care. The status of the BCG vaccine and its present indications as well as the future of new vaccines to achieve the old dream of eradicating this disease have been discussed. Finally, the ethical and medicolegal implications of this disease are not a minor issue and our situation in this regard has been reviewed.

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Pulmonary tuberculosis in intensive care setting, with a focus on the use of severity scores, a multinational collaborative systematic review

Cited by 17 publications

References 53 publications

Factors Affecting Mortality in Critically Ill Patients With Tuberculosis: A Systematic Review and Meta-Analysis

Factors Affecting Mortality in Critically Ill Patients With Tuberculosis: A Systematic Review and Meta-Analysis

Pulmonary tuberculosis complicated by pneumothorax, and acute respiratory distress syndrome (ARDS) in the settings of advanced HIV disease: A case report

Tuberculosis in Spain: An opinion paper

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