Journal of Medical and Surgical Intensive Care Medicine 2017 , Vol 8, Issue 2
Effects of Atrial Fibrillation on Intensive Care Unit Outcomes in Patients with Respiratory Failure
Müge Aydoğdu 1 , Çiğdem Hanazay 1 , Yağmur Aldağ 1 , Ayşe Baha 1 , Gül Gürsel 1 , Salih Bilgin 2
1Department and Critical Care Unit, Gazi University School of Medicine, Ankara, Turkey
2Clinic of Pulmonary Diseases, Medicana International Hospital, Samsun, Turkey
DOI : 10.5152/dcbybd.2017.1482

Objective: A negative impact of atrial fibrillation (AF) on clinical outcomes has been well defined in surgical intensive care unit (ICU) patients. However, some questions remain unanswered regarding the relationship between AF and ICU outcomes in patients with respiratory failure (RF). This study aims to determine the incidence of AF and its effects on ICU outcome among RF patients. In addition, the effects of bronchodilators on AF control, and cardiac medications on RF control, were also assessed.

Material and Methods: In this retrospective observational cohort study, electrocardiographs of all included RF patients were evaluated for AF. Patients were divided into two groups both for AF and mortality, and they were compared for demographics, diagnosis, comorbidities, risk factors, ICU outcomes, and cardiac and bronchodilator therapies.

Results: A 25% incidence of AF was found in a cohort of 147 patients (mean age 68±15years), and among them, 3% was newly diagnosed. There was no significant difference between the groups with respect to demographics, diagnoses, and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores of both groups. The incidence of heart failure and cerebrovascular event was found to be higher in patients with AF (p<0.05). There was no significant difference in sepsis, duration of mechanical ventilation, and ICU stay, but mortality and acute kidney injury were more common in AF patients (36% vs. 21% and 44% vs. 15% respectively, p<0.05). The mortality risk increased 3 times with AF OR(%95CI):3.09(0.91–10.3). There were no significant effects of bronchodilators on AF control and cardiac medications on RF control detected.

Conclusion: AF should be diagnosed and treated appropriately in RF patients. Bronchodilator and cardiac medications should not be avoided or withheld when indicated to prevent negative ICU outcomes.

Cite this article as: Aydoğdu M, Hanazay Ç, Aldağ Y, Bilgin S, Gürsel G. Effects of Atrial Fibrillation on Intensive Care Unit Outcomes in Patients With Respiratory Failure. Yoğun Bakım Derg 2017; 8: 32-8.

Keywords : Atrial fibrillation, respiratory failure, intensive care unit, mortality, outcome