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  • Open Access

Critical care outcome of pulmonary artery hypertension

  • 1,
  • 1,
  • 1,
  • 1 and
  • 1
Critical Care201115 (Suppl 1) :P494

https://doi.org/10.1186/cc9914

  • Published:

Keywords

  • Pulmonary Hypertension
  • Hospital Discharge
  • Critical Care
  • Inotropic Support
  • Average Survival

Introduction

Critical care (CC) outcome in pulmonary hypertension (PH) is not well documented, but is generally assumed to be poor. We therefore investigated the critical care outcome in 8 years of noncardiothoracic admissions to a PH supraregional centre.

Methods

We recorded the following data in PH patients admitted to CC: demography, aetiology, cardiovascular parameters including NYHA classification, R heart catheter and shuttle test distance (most recent assessment) along with organ support data. We recorded the length of stay (hours) in CC, CC and hospital outcome, 1-year survival and eventual outcome.

Results

Forty-seven patients were admitted (33 women), six required invasive ventilation, another six required non-invasive ventilation (NIV), 18 needed inotropic support and nine required CVVH. For survival to discharge, ROC analysis of shuttle distance demonstrated an asymptotic significance of P = 0.04 and an area of 0.71 (95% CI = 0.52 to 0.91) with 83% sensitivity and 65% specificity for a shuttle of 255 metres. Those with a shuttle over 255 metres had an average unit survival of 94%, 88% at hospital discharge and 47% at 1 year. Those below 255 metres had an average survival of 56%, 44% and 33%, respectively. Five out of six invasively ventilated patients died in hospital, but one lived for more than a year after discharge. Three out of six patients receiving NIV died in hospital but three lived for more than a year after discharge. Seventeen out of 18 who required inotropic support were dead at 1 year and 74% died before hospital discharge. For CVVH, five died and four lived. Overall survival: 64% survived to leave CC, 55% were discharged home alive and 34% were alive at 1 year. See Table 1.
Table 1

abstract

 

Age

NYHA

SpO2

RA

MPAP

CI

PVR

MVsats

Shuttle

LOS

Average

44

2.9

93

13

50

2.8

751

61

231

126

SD

18

0.6

6

9

14

1.1

324

12

125

154

Median

43

3

93

10

49

2.8

689

65

255

72

25th centile

29

3

92

5

40

2.0

515

54

92

43

75th centile

59

3

96

19

58

3.2

997

68

96

165

Conclusions

More than one-half of PH patients admitted to CC survive to be discharged home. Shuttle distance gives an indication of likely average survival.

Authors’ Affiliations

(1)
Sheffield Teaching Hospitals, Sheffield, UK

Copyright

© Philips et al. 2011

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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