Bolesnici liječeni u Jedinici intenzivnog liječenja Klinike za infektivne bolesti "Dr. Fran Mihaljević" u Zagrebu zbog bolesti COVID-19 Critically ill patients with COVID-19 treated in the Intensive Care Unit at the University Hospital for Infectious Diseases „Dr. Fran Mihaljević“ in Zagreb - Atelj, Anita; Krajinović, Vladimir; Santini, Marija; Papić, Neven; Vargović, Martina; Kotarski, Viktor; Gjurašin, Branimir, liječnik; Krznarić, Juraj; Kutleša, Marko, liječnik (2020)
Cilj: Opisati karakteristike bolesnika, tijek bolesti, terapiju te ishod i komplikacije kod kritično oboljelih s COVID-19 liječenih u Jedinici intenzivnog liječenja (JIL) Klinike za infektivne bolesti „Dr. Fran Mihaljević“ (KZIB) u Zagrebu. Materijali i metode: Opservacijska retrospektivna studija 38 odraslih bolesnika liječenih u JIL KZIB s dokazanim COVID-19 u razdoblju od 11. ožujka do 6. lipnja 2020. godine. Rezultati: Od ukupno 167 bolesnika s COVID-19 liječenih u KZIB, u JIL-u je liječeno 38 bolesnika (22,8%). Medijan dobi JIL bolesnika bio je 69.5 godina (33-85), umrlih 70 (43-85), a preživjelih 66 godina (33-80). Većina je bolesnika bila muškog spola (26 bolesnika ili 68%). Od komorbiditeta najčešći su bili arterijska hipertenzija (20- 53%), šećerna bolest (9-24%) te ishemijska bolest srca (8-21%). Svi su bolesnici primljeni zbog hipoksemijskog respiratornog zatajenja. Osim respiratornog zatajenja s primjenom mehaničke ventilacije u 30 (79%) bolesnika, česti su bili šok (25- 66%) te akutno bubrežno zatajenje (21- 55% bolesnika). Metode kontinuiranog nadomještanja bubrežne funkcije primjenjene su kod 13 (34%) bolesnika. Medijan trajanja hospitalizacije u JIL-u bio je 18 (3-68) dana, a mehaničke ventilacije 17 (5-43) dana. Ukupni je mortalitet bio 50%, a kod bolesnika koji su zahtijevali mehaničku ventilaciju 63%. Smrtnost je bila najveća u dobnoj skupini iznad 65. godine. Zaključak: Bolesnici s COVID-19, liječeni u JIL-u, često su i dugotrajno mehanički ventilirani, a tijekom boravka imaju brojne komplikacije bolesti i intenzivnog liječenja te visoku smrtnost. Najveća je smrtnost kod muškaraca starijih od 65 godina s arterijskom hipertenzijom, šećernom bolesti i ishemijskom bolesti srca.
Objective: To describe the characteristics, clinical course, treatment, outcomes and complications in critically ill patients with COVID-19 treated in the Intensive Care Unit (ICU) at the University Hospital for Infectious Diseases „Dr. Fran Mihaljević“ (UHID) in Zagreb. Materials and methods: A retrospective observational study of 38 adult patients with COVID-19 treated in the ICU at UHID between March 11 and June 6, 2020. Results: Among the 167 patients with COVID-19 treated at the UHID, 38 (22,8%) were admitted to the ICU. The mean age of these patients was 69.5 (33-85) years, 70 (43-85) years in deceased patients and 66 (33-80) in survivors. The majority of patients were male (26 patients- 68%). The most common comorbidities were arterial hypertension (20- 53%), diabetes mellitus (9- 24%) and ischaemic heart disease (8- 21%). All patients were admitted for hypoxaemic respiratory failure. In addition to acute respiratory failure with the need for mechanical ventilation (30- 79%), shock (25- 66%) and acute renal insufficiency (21- 55%) were common. Continuous renal replacement therapy was used in 13 (34%) patients. The median duration of ICU stay was 18 (3-68) days and of mechanical ventilation 19 (5-43) days. Overall mortality was 50%, 63% in patients who received mechanical ventilation and it was the highest in patients over 65 years of age. Conclusions: Patients with COVID-19, treated in the ICU, often require prolonged mechanical ventilation, have numerous complications of critical illness and ICU treatment, and high mortality rates. Mortality rate is highest in men over 65 years with comorbiditeies – arterial hypertension, diabetes mellitus and ischaemic heart disease.
Bibliografija: 26 jed.
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Keywords: COVID-19 -- Bolesnici -- Intenzivno liječenje; Klinika za infektivne bolesti "Dr. Fran Mihaljević" u Zagrebu