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Education, Teaching, and Quality Improvement |

Diabetes Mellitus and Duration of Ventilatory Support in Patients With Acute Respiratory Failure Due to Exacerbation of COPD

Danae Delivanis, MD; N. Burki, MD; D. Datta, MD
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University of CT Health Center, Farmington, CT


Chest. 2013;144(4_MeetingAbstracts):554A. doi:10.1378/chest.1701258
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Abstract

SESSION TITLE: Outcomes/Quality Control Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: Hyperglycemia is associated with poor outcomes in several acute illnesses including acute exacerbation of COPD. Whether the presence of underlying diabetes mellitus adversely affects outcome in these patients with acute respiratory failure has not been studied. A recent retrospective study in this group of patients at our institution had revealed that diabetes mellitus affected hospital length of stay (LOS) but not ICU LOS. The objective of this study was to determine if the presence of diabetes mellitus (DM) in patients with acute respiratory failure due to acute exacerbation of COPD adversely affected duration of ventilatory support.

METHODS: We retrospectively reviewed the records of 75 patients admitted to the ICU of our institution with acute exacerbation of COPD causing acute respiratory failure. Data obtained from records included patient demographics, number of patients with DM and modes of treatment of acute respiratory failure - invasive mechanical ventilation, non-invasive mechanical ventilation or only Oxygen(O2) therapy. Duration of ventilatory support of patients with and without DM was determined. Univariate logistic regression analysis was performed to evaluate the effect of diabetes on duration of ventilatory support. Paired t-test was performed to determine the difference in these outcomes between diabetic and non-diabetic patients. p < 0.05 was deemed statistically significant.

RESULTS: Mean age of studied patients was 72.4±11 years; 54% of the patients were females. Thirty-seven patients (49%) had DM. Ninety-four percent received ventilatory support (including invasive mechanical ventilation and non-invasive mechanical ventilation) and 6% received only O2 therapy via Ventimask. Mean glucose at admission was 175 ± 92mg% in diabetics and 138 ± 32mg% in non-diabetics (p= 0.02). Duration of ventilatory support was 3.9±4 days in patients with DM and 2.3±1 days in patients without DM (p=0.02).

CONCLUSIONS: Diabetes mellitus was associated with a significantly longer duration of ventilatory support in patients with acute respiratory failure due to acute exacerbation of COPD.

CLINICAL IMPLICATIONS: Prospective studies are needed to confirm these findings and determine if tighter glycemic control might reduce duration of ventilatory support in these patients.

DISCLOSURE: The following authors have nothing to disclose: Danae Delivanis, N. Burki, D. Datta

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