Severe diffuse alveolar hemorrhage related to autoimmune disease: a multicenter study - Université Paris Cité Accéder directement au contenu
Article Dans Une Revue Critical Care Année : 2020

Severe diffuse alveolar hemorrhage related to autoimmune disease: a multicenter study

Antoine Parrot
Nicolas de Prost
Mathilde Neuville
Naïke Bigé
Jacques Cadranel
  • Fonction : Auteur
  • PersonId : 901162

Résumé

Background: Diffuse alveolar hemorrhage (DAH) occurs during the course of autoimmune disease and may be life threatening. The objective was to assess characteristics and prognosis factors of DAH who required intensive care unit (ICU) admission in patients with autoimmune diseases. Methods: French multicenter retrospective study including patients presenting DAH related to autoimmune diseases requiring ICU admission from 2000 to 2016. Results: One hundred four patients (54% of men) with median age of 56 [32-68] years were included with 79 (76%) systemic vasculitis and 25 (24%) connective tissue disorders. All patients received steroids, and 72 (69%), 12 (11.5%), and 57 (55%) patients had cyclophosphamide, rituximab, and plasma exchanges, respectively. During ICU stay, 52 (50%), 36 (35%), and 55 (53%) patients required mechanical ventilation, vasopressor use, and renal replacement therapy, respectively. Factors associated with mechanical ventilation weaning were age (HR [95%CI] 0.97 [0.96-0.99] per 10 years, p < 0.0001), vasculitis-related DAH (0.52 [0.27-0.98], p = 0.04), and time from dyspnea onset to ICU admission (0.99 [0.99-1] per day, p = 0.03). ICU mortality was 15%. Factors associated with alive status at ICU discharge were chronic cardiac failure (HR [95%CI] 0.37 [0.15-0.94], p = 0.04), antiphospholipid syndrome-related DAH (3.17 [1.89-5.32], p < 0.0001), SAPS II (0.98 [0.97-0.99], p = 0.007), and oxygen flow at ICU admission (0.95 [0.91-0.99] per liter/min, p = 0.04). Conclusion: DAH in autoimmune diseases is a life-threatening complication which requires mechanical ventilation in half of the cases admitted to ICU.
Fichier principal
Vignette du fichier
s13054-020-02936-0.pdf (740.83 Ko) Télécharger le fichier
Origine : Publication financée par une institution
Loading...

Dates et versions

hal-02625921 , version 1 (26-05-2020)

Identifiants

Citer

Adrien Mirouse, Antoine Parrot, Vincent Audigier, Alexandre Demoule, Julien Mayaux, et al.. Severe diffuse alveolar hemorrhage related to autoimmune disease: a multicenter study. Critical Care, 2020, 24 (1), ⟨10.1186/s13054-020-02936-0⟩. ⟨hal-02625921⟩
283 Consultations
148 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More