The Science Journal of the American Association for Respiratory Care

2007 OPEN FORUM Abstracts

MECHANICAL VENTILATION IN PATIENTS WITH LEPTOSPIROSIS: A STUDY OF CLINICAL OUTCOME.

S. Johnson1, H. Tatineni1, H. N. Kumar1

BACKGROUND
Leptospirosis is a bacterial disease caused by the genus Leptospirosis. It is commonly transmitted through rodents and hence is common in rural areas. Complications include renal failure, liver dysfunction, haematological abnormalities and respiratory distress. This case series analyses the requirement of ventilation, duration of ICU stay and outcome in patients with leptospirosis.

METHOD
This is a retrospective and epidemiological study of patients with leptospirosis who required mechanical ventilation. The period of study was from 1.1.2006 to 31.12.2006. A total of 75 patients were admitted with a diagnosis of leptospirosis at Kasturba Medical College Hospital, Manipal. Five patients could not afford treatment and were discharged against medical advice. The remaining 70 patients were included in the study.

RESULTS
A total of nine patients (12.7%) required mechanical ventilation. The age of the patients was 45.2 ± 12.84 (mean ± SD) years. There were 4 male and 5 female patients.

They were ventilated for an average of 4.78±3.89 days (mean ± SD). One of these patients improved with noninvasive positive pressure ventilation (6 days) alone. None of the patients was tracheostomised. The duration of hospital stay was 9.7 ± 7.72 days (mean ± SD).

The mortality rate of patients with leptospirosis requiring mechanical ventilation was high (66.67%).  They succumbed to complications such as renal failure, acute respiratory distress syndrome and multi-organ dysfunction syndrome.

CONCLUSION
This study suggests that although only a small percentage of patients with Leptospirosis develop respiratory failure and require mechanical ventilation, they have a high mortality rate.


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