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Annemarie Musch

Publications and source records attributed to Annemarie Musch.

24 records · Page 2Linked to original sources
PubMed2004

Does intubation really equal death in cirrhotic patients? Factors influencing outcome in patients with liver cirrhosis requiring mechanical ventilation.

OBJECTIVE: It is not known whether the poor outcome of ventilated cirrhotic patients is related to the severity of the underlying liver disease or to the severity of the acute illness for which ICU care is required. This study examines parameters both of chronic liver disease and of acute illness with regard to their influence on outcome in mechanically ventilated cirrhotic patients. DESIGN AND SETTING: Retrospective observational case series in a 9-bed medical ICU in an academic tertiary care center. PATIENTS AND MEASUREMENTS: Seventy-six consecutive cirrhotic patients who received mechanical ventilation were identified. Clinical and laboratory parameters were compared between ICU survivors and ICU deaths. RESULTS: There were 45/76 (59%) patients who died during their ICU stay. By univariate analysis, the Child-Pugh score, its components (serum bilirubin, prothrombin time), ALT, creatinine concentration, a clinical suspicion of infection, and the APACHE II score, but not the acute physiology score (APS), differed significantly between ICU survivors and ICU non-survivors. The Child-Pugh score was highly correlated to ICU mortality both in logistic regression analysis and receiver-operating characteristics analysis. Conversely, markers of acute illness, in particular the APS component of the APACHE II score, did not predict ICU survival. CONCLUSIONS: Markers of advanced chronic liver disease but not of the severity of acute illness are correlated to ICU outcome in ventilated cirrhotic patients. The outcome of advanced cases (Child-Pugh score of 12 and above) is poor.

Adolescent↗
PubMed2004

Outcome of patients with acute myeloid leukemia and pulmonary infiltrates requiring invasive mechanical ventilation-a retrospective analysis.

PURPOSE: To assess the prognosis of patients with acute myeloid leukemia (AML) and pulmonary infiltrates requiring mechanical ventilation. DESIGN: A retrospective cohort study. SETTING: A medical intensive care unit (ICU) in an academic tertiary care center. PATIENTS AND METHODS: We identified 30 consecutive patients with acute myeloid leukemia and pulmonary infiltrates who received invasive mechanical ventilation and compared clinical and laboratory parameters between ICU survivors and ICU non-survivors using non-parametric statistics. RESULTS: The overall mortality rate was 87% (26/30). The survival was 40 % (4/10) for patients aged 50 years or less while none (0/20) of the patients older than 50 years survived (P <.02). The median time of mechanical ventilation in survivors was 23.5 (3-45) days. No differences between survivors and non-survivors were observed for the APACHE II score, oxygenation quotient, liver function tests, creatinine, blood urea nitrogen, or prognostic parameters of acute myeloid leukemia (presence of blasts on bone marrow aspirate, cytogenetic studies, and intensity of the chemotherapy regimen). CONCLUSIONS: Age seems to be an important prognostic parameter in our cohort of 30 consecutive patients with acute myeloid leukemia and pulmonary infiltrates requiring mechanical ventilation. Prolonged ventilation does not preclude survival.

Adolescent↗