Mortality Associated with Intensive Care Unit Admission and Mechanical Ventilation in Adults with Acute Chest Syndrome: A Systematic Review.

What was studied

This review looked at adults with acute chest syndrome from sickle cell disease. It focused on those treated in intensive care or on a breathing machine. It asked about deaths, length of stay and complications. Reported death rates vary widely. The team searched many databases without a date limit. Studies differed too much to pool. So the results were summarised in words. Quality was rated with the Newcastle-Ottawa Scale.

What they found

The studies were cohorts, national database studies and one before-after study. Death in hospital was low, but death with follow-up was higher in one ICU group. Ventilation was the strongest sign of death. In the largest national group, short ventilation had an odds ratio of 67.53. Long ventilation had 8.73. Bacterial infection was rare, despite frequent antibiotic use. Stopping antibiotics by procalcitonin level safely cut their use. All included studies were rated high quality.

What it means for patients

They say ventilation was the strongest sign of poor outcome. Lung blood pressure problems and other illness were also consistent signs. They say the findings support early recognition and antibiotic stewardship. They also back respiratory support by severity.

Why it is not certain yet

The authors say the findings need cautious reading. Results were put in words, not pooled. The people studied were mixed. The studies came from a narrow set of places. A review can only be as good as the studies in it.

Source

Mortality Associated with Intensive Care Unit Admission and Mechanical Ventilation in Adults with Acute Chest Syndrome: A Systematic Review.

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