Prognostic factors and outcome of mechanically ventilated interstitial lung disease patients

Abstract

BackgroundThe prognosis of mechanically ventilated interstitial lung disease (ILD) patients was controversial in previous studies. Identifying the factors associated with mortality could guide therapy and allow good use of ICU resources.AimThe aim was to study the outcome of ILD mechanically ventilated patients admitted to the respiratory ICU and to demonstrate the possible factors associated with mortality in these patients.Patients and methodsThe observational prospective study was carried out on ILD patients undergoing mechanical ventilation, either invasive mechanical ventilation (IMV) or noninvasive ventilation (NIV). Clinical, radiological, and outcome assessments were done for all enrolled patients. For outcome assessment, patients were classified into either survivors or nonsurvivors.ResultsTwenty-one (70%) of the patients were subjected to NIV, whereas nine (30%) of them were subjected to IMV. The overall mortality rate was 53.3%. However, the mortality rate was 35% in patients with NIV, but 100% in patients with IMV. Severity assessment scores were significantly higher in nonsurvivors compared with survivors. Nonsurvivors also presented significantly with lower pH and higher PaCO2 compared with survivors. Acute Physiology and Chronic Health Evaluation-II score greater than or equal to 18.5, Simplified Acute Physiology Score greater than or equal to 27.5, Glasgow coma scale score less than 12.5 and PaO2/ FiO2 less than 161.5 were associated with increased risk of mortality of ILD patients.ConclusionMechanically ventilated ILD patients had a poor outcome. However, the survival rate of ILD patients was better on NIV than IMV. Severity assessment scores and PaO2/FiO2 could predict the risk of mortality in ILD patients.