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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Clinical features of invasive bronchial-pulmonary aspergillosis in critically ill patients with chronic obstructive respiratory diseases: a prospective study. | He et al. Critical Care 2011 15 R5 http ccforum.eom content 15 1 R5 KS CRITICAL CARE RESEARCH Open Access Clinical features of invasive bronchial-pulmonary aspergillosis in critically ill patients with chronic obstructive respiratory diseases a prospective study Hangyong HeH Lin Ding1 f Fang Li2 Qingyuan Zhan1 Abstract Introduction Critically ill patients with chronic obstructive respiratory diseases CORD who require intensive care unit ICU admission are at particular risk for invasive bronchial-pulmonary aspergillosis IBPA . The purpose of this study is to investigate clinical features for rapid recognition of IBPA in critically ill patients with CORD. Methods We included 55 consecutive CORD patients in a respiratory ICU in a prospective single-center cohort study. In this study IBPA combined two entities ATB and IPA. Results Thirteen of 55 patients were diagnosed with IBPA. Before ICU admission three variables were independent predictors of IBPA with statistical significance more than three kinds of antibiotics used before the ICU admission accumulated doses of corticosteroids 350 mg received before the ICU admission and APACHE II scores 18 OR 1.208 P 0.022 OR 8.661 P 0.038 and OR 19.488 P 0.008 respectively . After ICU admission more IBPA patients had a high fever 38.5 C 46.2 versus 11.9 P 0.021 wheeze without exertion 84.6 versus 50.0 P 0.027 dry rales 84.6 versus 40.4 P 0.005 higher white blood cell counts 21 X 109 L versus 9.4 X 109 L P 0.012 lower mean arterial pressures 77.9 mm Hg versus 90.5 mm Hg P 0.019 and serum creatinine clearances 36.2 ml min versus 68.8 ml min P 0.001 and liver-function and coagulation abnormalities. Bronchospasm sputum ropiness and plaque formation were more common for IBPA patients during bronchoscopy 66.7 versus 14.3 P 0.082 18 versus 0 P 0.169 and 73 versus 13 P 0.003 respectively . More IBPA patients had nodules and patchiness on chest radiograph on day 1 of admission which rapidly progressed to consolidation on day 7. IBPA .
