Changes of disease spectrum and main therapeutic interventions in respiratory intensive care unit_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

LI Yingzhi , YANG Kai , CHEN Yanru , YANG Wan , CAI Jie , YANG Peng ,  TAO Weihua

Department of Respiratory and Critical Care Medicine, Shenzhen Institute of Respiratory Diseases, Shenzhen People's Hospital (the First Affiliated Hospital of Southern University of Science and Technology), Shenzhen, Guangdong 518001, P. R. China;

Corresponding author：

TAO Weihua, Email: sztwh333@126.com

Keywords：

Respiratory intensive care unit; Disease spectrum; Diagnosis and treatment technology; Discipline development

DOI：

10.7507/1671-6205.202103021

Video：

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Objective To analyze the trend of disease spectrum and main diagnosis and therapeutic technologies in respiratory intensive care unit (RICU) in recent years, and find out the trend of change of patient’s characteristics and commonly used interventions in order to provide evidence for planning discipline development and improving personnel training program.Methods Patients information and main diagnosis and therapeutic technologies of 1503 inpatients in RICU of Shenzhen People's Hospital from January, 2017 to December, 2020 were collected. The changes of disease spectrum and diagnosis and treatment technologies in different years were compared and analyzed.Results Among all the patients, 66.3% were directly admitted into RICU, 12.1% were transferred from respiratory department, and 21.6% were transferred from other departments. The proportion of patients with non-respiratory diseases as principal diagnosis had an increasing trend, from 18.8% in 2017 to 37.3% in 2020 (P<0.05). The diseases with most obvious increasing trend were sepsis, nervous system diseases, circulatory system diseases and extra-pulmonary malignancies (P<0.05). The use of respiratory related diagnosis and therapeutic technologies was gradually increasing, meanwhile, the use of non-traditional respiratory related technologies, especially continuous renal replacement therapy, was also increasing. There was no significant difference in fatality rate among different years (P>0.05).Conclusions The number of patients with extra-pulmonary diseases and the use of non-traditional respiratory related diagnosis and therapeutic technologies in RICU were increasing. The development of RICU and the allocation of technical personnel needed to be improved accordingly.

Citation： LI Yingzhi, YANG Kai, CHEN Yanru, YANG Wan, CAI Jie, YANG Peng, TAO Weihua. Changes of disease spectrum and main therapeutic interventions in respiratory intensive care unit. Chinese Journal of Respiratory and Critical Care Medicine, 2021, 20(4): 261-265. doi: 10.7507/1671-6205.202103021 Copy

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11.	Fuchs L, Novack V, McLennan S, et al. Trends in severity of illness on ICU admission and mortality among the elderly. PLoS One, 2014, 9(4): e93234.
12.	Pistone A, Durieux V, Grigoriu B, et al. Management of acute complications of targeted therapy in patients with cancer: a review of cases managed in ICU. J Intensive Care Med, 2019, 34(6): 435-448.
13.	郑慧峰, 张萌, 刘奕, 等. 2012-2017年ICU老年患者疾病谱及死因分析. 现代医药卫生, 2019, 35(11): 1713-1716.
14.	Sjoding M, Prescott H, Wunsch H, et al. Longitudinal changes in ICU admissions among elderly patients in the United States. Crit Care Med, 2016, 44(7): 1353-1360.
15.	Kim D, Lee M, Lee S, et al. Survival rates following medical intensive care unit admission from 2003 to 2013: An observational study based on a representative population-based sample cohort of Korean patients. Medicine, 2019, 98(37): e17090.
16.	Herer B. Outcomes of prolonged mechanical ventilation before and after implementation of a respiratory ICU. Respir Care, 2020, 65(7): 1011-1018.
17.	Donovan A, Aldrich J, Gross A, et al. Interprofessional care and teamwork in the ICU. Crit Care Med, 2018, 46(6): 980-990.
18.	Andre A. The formation, elements of success, and challenges in managing a critical care program: part I. Crit Care Med, 2015, 43(4): 874-879.

1. 乔人立. 美国呼吸与危重症医学专科的形成与发展. 中华结核和呼吸杂志, 2013, 36(2): 139-140.
2. Qiao R, Rosen M, Chen R, et al. Establishing pulmonary and critical care medicine as a subspecialty in China: joint statement of the Chinese thoracic society and the American college of chest physicians. Chest, 2014, 145(1): 27-29.
3. Qiao R, Marciniuk D, Buckley J, et al. The strategic establishment of pulmonary and critical care medicine as a subspecialty in China: Third Report From the China-CHEST PCCM Fellowship Project. Chest, 2020, 157(5): 1082-1085.
4. Wu S, Qiao R, Wang C. PCCM at the battlefront against COVID-19 in Wuhan, China. Chest, 2020, 158(2): 474-476.
5. Joyce C, Howell J, Toal M, et al. Critical care for coronavirus disease 2019: perspectives from the PICU to the medical ICU. Crit Care Med, 2020, 48(11): 1553-1555.
6. Tamul P, Peruzzi W. Assessment and management of patients with pulmonary disease. Crit Care Med, 2004, 32(4 Suppl): S137-S145.
7. 中国医师协会急诊医师分会, 中国研究型医院学会休克与脓毒症专业委员会. 中国脓毒症/脓毒性休克急诊治疗指南(2018). 临床急诊杂志, 2018, 19(9): 567-588.
8. Cillóniz C, Dominedò C, Pericàs JM, et al. Community-acquired pneumonia in critically ill very old patients: a growing problem. Eur Respir Rev, 2020, 29(155): 190126.
9. Pellicori P, Cleland J, Clark A. Chronic obstructive pulmonary disease and heart failure: a breathless conspiracy. Heart Fail Clin, 2020, 16(1): 33-44.
10. Borgne P, Maestraggi Q, Couraud S, et al. Critically ill elderly patients (≥ 90 years): clinical characteristics, outcome and financial implications. PLoS One, 2018, 13(6): e0198360.
11. Fuchs L, Novack V, McLennan S, et al. Trends in severity of illness on ICU admission and mortality among the elderly. PLoS One, 2014, 9(4): e93234.
12. Pistone A, Durieux V, Grigoriu B, et al. Management of acute complications of targeted therapy in patients with cancer: a review of cases managed in ICU. J Intensive Care Med, 2019, 34(6): 435-448.
13. 郑慧峰, 张萌, 刘奕, 等. 2012-2017年ICU老年患者疾病谱及死因分析. 现代医药卫生, 2019, 35(11): 1713-1716.
14. Sjoding M, Prescott H, Wunsch H, et al. Longitudinal changes in ICU admissions among elderly patients in the United States. Crit Care Med, 2016, 44(7): 1353-1360.
15. Kim D, Lee M, Lee S, et al. Survival rates following medical intensive care unit admission from 2003 to 2013: An observational study based on a representative population-based sample cohort of Korean patients. Medicine, 2019, 98(37): e17090.
16. Herer B. Outcomes of prolonged mechanical ventilation before and after implementation of a respiratory ICU. Respir Care, 2020, 65(7): 1011-1018.
17. Donovan A, Aldrich J, Gross A, et al. Interprofessional care and teamwork in the ICU. Crit Care Med, 2018, 46(6): 980-990.
18. Andre A. The formation, elements of success, and challenges in managing a critical care program: part I. Crit Care Med, 2015, 43(4): 874-879.

Chinese Journal of Respiratory and Critical Care Medicine

Changes of disease spectrum and main therapeutic interventions in respiratory intensive care unit

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