부산대학교 도서관

Byline: Didier Gruson (1), Frederic Vargas (1), Gilles Hilbert (1), Nam Bui (1), Thierry Maillot (2), Thierry Mayet (1), Odile Pillet (1), Genevieve Chene (1,3), Georges Gbikpi-Benissan (1) Keywords: Critical care; Bone marrow transplantation; Pneumonia; Acute respiratory failure; Intensive care unit; Outcome Abstract: Objective To describe early signs at the onset of pneumonia occurring in the haematology ward which could be associated with a transfer to the ICU. Design A 13-month preliminary prospective observational cohort study. Setting Department of haematology and (32-bed) medical intensive care unit (ICU). Patients Fifty-three of 302 patients hospitalised in the haematology ward who developed presumptive clinical evidence of pneumonia were enrolled. Measurements and results At the onset of the clinical evidence of pneumonia (day 1), we compared variables between patients requiring an ICU admission and those who did not. Twenty-four patients (45%) required a transfer to the ICU. Factors associated with ICU admission were: numbers of involved quadrants: 2.3 vs 1, P=0.001 and oxygenation parameters (initial level of O.sub.2 supplementation: 3.5 vs 0.9 l/min, P Conclusion Parameters of oxygenation and radiological score could be associated with this transfer on day 1 of the onset of pneumonia occurrence. A further study should evaluate an earlier selection of this type of patient, followed by an 'early' admission to the MICU, in order to improve ICU outcome. Author Affiliation: (1) Department of Medical Intensive Care Unit, Units 1 and 2, University Hospital, Place Amelie Raba-Leon, Bordeaux, France (2) Department of Haematology, University Hospital, Pessac, France (3) Clinical Epidemiology Unit, University Hospital, Bordeaux, France Article History: Registration Date: 24/02/2004 Online Date: 30/03/2004