自身免疫性风湿性疾病的急性呼吸衰竭:综述。
Acute Respiratory Failure in Autoimmune Rheumatic Diseases: A Review.
发表日期:2024 May 20
作者:
Sofia Poli, Francesca Sciorio, Giorgio Piacentini, Angelo Pietrobelli, Luca Pecoraro, Sara Pieropan
来源:
Arthritis & Rheumatology
摘要:
本综述探讨了重症监护病房 (ICU) 内自身免疫性风湿性疾病的呼吸系统并发症。呼吸系统主要受到类风湿性关节炎、系统性红斑狼疮和硬皮病等疾病的影响,常常导致呼吸衰竭。常见表现包括肺泡出血、间质纤维化和急性呼吸窘迫综合征。早期识别和治疗非恶性疾病对于防止疾病快速进展至关重要,ICU 死亡率为 30% 至 60%。延迟免疫抑制或抗菌治疗可能会导致器官系统衰竭。与风湿病专家的合作对于准确诊断和立即干预至关重要。重症监护病房中风湿病的死亡率高于其他疾病,这凸显了专业护理和积极管理的必要性。该综述强调全面评估、区分疾病相关并发症和潜在问题,以及警惕监测对提高患者治疗效果的重要性。
This review examines respiratory complications in autoimmune rheumatic diseases within intensive care units (ICUs). The respiratory system, primarily affected in diseases like rheumatoid arthritis, systemic lupus erythematosus, and scleroderma, often leads to respiratory failure. Common manifestations include alveolar hemorrhage, interstitial fibrosis, and acute respiratory distress syndrome. Early recognition and treatment of non-malignant conditions are crucial to prevent rapid disease progression, with ICU mortality rates ranging from 30% to 60%. Delayed immunosuppressive or antimicrobial therapy may result in organ system failure. Collaboration with rheumatic specialists is vital for accurate diagnosis and immediate intervention. Mortality rates for rheumatic diseases in the ICU surpass those of other conditions, underscoring the need for specialized care and proactive management. The review emphasizes comprehensive assessments, distinguishing disease-related complications from underlying issues, and the importance of vigilant monitoring to enhance patient outcomes.