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Semin Respir Crit Care Med 2020; 41(06): 806-816
DOI: 10.1055/s-0040-1710074
Review Article

Comorbidities and Readmissions in Survivors of Acute Hypercapnic Respiratory Failure

Dan Adler
1   Division of Lung Diseases, Geneva University Hospitals, Geneva, Switzerland
2   Faculty of Medicine, University of Geneva Medical School, Geneva, Switzerland
,
Giulia Cavalot
3   Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada
4   Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada
5   Division of Internal Medicine, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
,
Laurent Brochard
3   Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada
4   Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada
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Abstract

Chronic obstructive pulmonary disease (COPD) is defined by chronic airflow obstruction, but is presently considered as a complex, heterogeneous, and multicomponent disease in which comorbidities and extrapulmonary manifestations make important contributions to disease expression. COPD-related hospital readmission. In particular frequent intensive care unit (ICU) readmissions for exacerbations represent a major challenge and place a high burden on patient outcomes and health-related quality of life, as well as on the healthcare system.

In this narrative review, we first address major and often undiagnosed comorbidities associated with COPD that could have an impact on hospital readmission after an index ICU admission for acute hypercapnic respiratory failure. Some guidance for treatment is discussed. Second, we present predictors of hospital and ICU readmission and discuss various strategies to reduce such events.

There is a strong rationale to detect and treat major comorbidities early after index ICU admission for acute hypercapnic respiratory failure. It still remains unclear, however, if a comprehensive and holistic approach to comorbidities in frail patients surviving hypercapnic respiratory failure can efficiently reduce the readmission rate.

Keywords

hypercapnia - acute hypercapnic respiratory failure - COPD - ICU - noninvasive ventilation - readmission - outcome


Publication History

Article published online:
03 August 2020

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