OUTCOMES OF TREATMENT OF PATIENTS IN THE INTENSIVE CARE UNIT OF THE CLINIC FOR PULMONARY DISEASES OF KBC SPLIT, IN THE PERIOD FROM MARCH TO JUNE 2021

CILJ ISTRAŽIVANJA: Svrha istraživanja je bila ispitati klinički ishod u hospitaliziranih bolesnika, učinkovitost SAPS II zbroja u procjeni smrtnog ishoda u bolesnika, učestalost liječenja invazivnim, neinvazivnim tehnikama ventilacije, kao i procijeniti učestalost primjene antibiotske terapije u pacijenata liječenih u jedinici intenzivne njege Klinike za plućne bolesti KBC-a Split. MATERIJALI I METODE: Ispitanici su odrasle osobe oba spola, starije od 18 godina, hospitalizirane u Jedinici intenzivne njege Klinike za plućne bolesti KBC-a Split u razdoblju od ožujka do lipnja 2021. godine. Uključeni su bolesnici koji su zbog očigledne ili prijeteće ugroženosti disanja zahtijevali intenzivno liječenje. Nisu uključeni bolesnici koji su u Jedinici intenzivnog liječenja bili hospitalizirani kraće od 24 sata. Bilježene su sljedeće varijable: dob, spol, prijemna dijagnoza, duljina boravka u jedinici intenzivne njege, sveukupna duljina boravka u bolnici, Glasgow coma score (GCS) po dolasku, vrijednosti arterijskog krvnog tlaka, komorbiditeti, vrijednost SAPS II zbroja u prva 24 sata od prijema, ishodi liječenja (smrtnost, premještaj i otpust), acidobazni status, laboratorijski biljezi upale, NT pro-BNP, hsTnT, ukupni bilirubin, protok i način primjene kisika te očekivani FiO2 i ostala terapija kojom su liječeni (kortikosteroidi, bronhodilatatori, heparin). REZULTATI: U istraživanju je sudjelovalo 62 bolesnika, medijan dobi bolesnika iznosio je 66, a u više od četiri petine bolesnika bio je prisutan barem jedan komorbiditet. Najčešći razlog dolaska bila je respiracijska insuficijencija najčešće uzrokovana pneumonijom (65% bolesnika). Analizom pozitivnih mikrobioloških nalaza utvrđeno je da se među izolatima (aspirat bronha, bris nosa, hemokultura, bris rektuma, bris kože) najčešće pronalazio Acinetobacter baumannii. Više od 80% bolesnika liječeno je antibiotikom. Strojnom ventilacijom, u obliku invazivne i neinvazivne mehaničke ventilacije je liječeno 50% pacijenata, invazivnu mehaničku ventilaciju zahtijevalo je 11% pacijenata, a neizvazivnu mahničku ventilaciju (NIV) 39% pacijenata. Pedeset posto je liječeno kisikom bez ventilacijske potpore. Središnja vrijednost SAPS II zbroja iznosila je 32. ZAKLJUČAK: Vrijednosti SAPS II zbroja nakon prijema bile su značajno veće u osoba koje su umrle u odnosu na osobe koje su preživjele.OBJECTIVES: The purpose of the study was to examine the clinical outcome in hospitalized patients, the effectiveness of SAPS II sum in assessing mortality in patients, the frequency of treatment with invasive, non-invasive ventilation techniques, and to evaluate the frequency of antibiotic therapy in patients treated in respiratory intensive care unit of Clinical Hospital Center Split. PATIENTS AND METHODS: Subjects are adults both sexes, older than 18 years, hospitalized in the Intensive Care Unit of the Clinic for pulmonary diseases of the Clinical Hospital Center Split in the period from March to June 2021. Patients who required intensive treatment due to obvious or threatened respiratory distress were included. Patients who were hospitalized for less than 24 hours in the Intensive Care Unit were not included. The following variables were: age, sex, admission diagnosis, length of stay in the Intensive Care Unit, total length of hospital stay, Glasgow coma score (GCS) on arrival, arterial blood pressure values, comorbidities, SAPS II score in first 24 hours of admission, treatment outcomes (mortality, transfer and discharge), acid-base status, laboratory markers of inflammation, NT pro-BNP, hsTnT, total bilirubin, oxygen flow and mode, and expected FiO2 and other therapies (corticosteroids, bronchodilatators, heparin). RESULTS: 62 patients participated in the study, median was 66, and in more than four-fifths of patients at least one comorbidity was present. The most common reason for arrival was respiratory insufficiency most often caused by pneumonia (65% of patients). The analysis of positive microbiological findings showed that Acinetobacter baumanni is most often found among isolates (bronchial aspirate, nasal swab, blood culture, rectal swab, skin swab). More than 80% of patients in therapy received antibiotics. The need for mechanical ventilation, in the form of invasive and non-invasive mechanical ventilation, was required by 40% of patients, invasive mechanical ventilation was required by 11% of patients, and non-invasive mechanical ventilation (NIV) by 39% of patients. Fifty percent of patients received oxygen therapy alone. The mean value of the SAPS II score was 32. CONCLUSION: The values of the SAPS II sum after admission were significantly higher in people who died than in the survivor