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The impact of cormorbid conditions on critical illness.

The impact of cormorbid conditions on critical illness.

Crit Care Med. 2011 Dec;39(12):2728-35

Authors: Esper AM, Martin GS

Abstract
OBJECTIVE: To review the current knowledge of common comorbidities in the intensive care unit, including diabetes mellitus, chronic obstructive pulmonary disease, cancer, end-stage renal disease, end-stage liver disease, HIV infection, and obesity, with specific attention to epidemiology, contribution to diseases and outcomes, and the impact on treatments in these patients.
DATA SOURCE: Review of the relevant medical literature for specific common comorbidities in the critically ill.
RESULTS: Critically ill patients are admitted to the intensive care unit for various reasons, and often the admission diagnosis is accompanied by a chronic comorbidity. Chronic comorbid conditions commonly seen in critically ill patients may influence the decision to provide intensive care unit care, decisions regarding types and intensity of intensive care unit treatment options, and outcomes. The presence of comorbid conditions may predispose patients to specific complications or forms of organ dysfunction. The impact of specific comorbidities varies among critically ill medical, surgical, and other populations, and outcomes associated with certain comorbidities have changed over time. Specifically, outcomes for patients with cancer and HIV have improved, likely related to advances in therapy. Overall, the negative impact of chronic comorbidity on survival in critical illness may be primarily influenced by the degree of organ dysfunction or the cumulative severity of multiple comorbidities.
CONCLUSION: Chronic comorbid conditions are common in critically ill patients. Both the acute illness and the chronic conditions influence prognosis and optimal care delivery for these patients, particularly for adverse outcomes and complications influenced by comorbidities. Further work is needed to fully determine the individual and combined impact of chronic comorbidities on intensive care unit outcomes.

PMID: 22094497 [PubMed - indexed for MEDLINE]

Impact of Anxiety and Depression on COPD Exacerbation Risk.

Authors: Laurin C, Moullec G, Bacon SL, Lavoie KL Abstract Chronic Obstructive Pulmonary Disease (COPD) exacerbations contribute significantly to morbidity and mortality. COPD is also associated with high levels of psychological distress, which has been linked with higher exacerbation rates. At a recent ATS Conference symposium titled "Depression and Obstructive Lung Disease: State of the Science and Future Directions" held in 2010 in New Orleans, clinicians and researchers identified a number of important research priorities related to psychiatric co-morbidities, including the need to better understand their impact on COPD outcomes, such as exacerbations. This paper will review the current literature and quantify the prospective impact of anxiety and depression on exacerbation ris...

Lung 18F-fluorodeoxyglucose PET for Diagnosis and Monitoring of Pulmonary Arterial Hypertension.

CONCLUSIONS: HIF-1α-mediated Glut1 upregulation in proliferating vascular cells in PAH accounts for increased lung FDG-PET uptake. FDG-PET is sensitive to mild PAH and can monitor therapeutic changes in the vasculature. PMID: 22246173 [PubMed - as supplied by publisher] (Source: American Journal of Respiratory and Critical Care Medicine)

Airway clearance in bronchiectasis: breaking the infection-inflammation cycle.

Authors: Stirling RG, Nicolson CH, Button BM, Wilson JW PMID: 22246705 [PubMed - in process] (Source: American Journal of Respiratory and Critical Care Medicine)

Noninvasive Ventilation for Acute Exacerbations of Chronic Obstructive Pulmonary Disease: "Don't Think Twice, It's Alright!".

Noninvasive Ventilation for Acute Exacerbations of Chronic Obstructive Pulmonary Disease: "Don't Think Twice, It's Alright!". Am J Respir Crit Care Med. 2012 Jan 15;185(2):121-3 Authors: Elliott MW, Nava S PMID: 22246701 [PubMed - in process] (Source: American Journal of Respiratory and Critical Care Medicine)

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