• Antoine Gaillet, Pierre Bay, Edwige Péju, Hafid Ait-Oufella, Elie Azoulay, Nacime Benchabane, Charles Cerf, Yves Cohen, Nicolas de Prost, Stanislas Faguer, Guillaume Geri, Steven Grangé, Jean-Emmanuel Kahn, Louis Kreitmann, Romaric Larcher, Guillaume Lefèvre, Asma Mabrouki, Armand Mekonsto-Dessap, Kewin Panel, Frédéric Pène, Pineton de ChambrunMarcMMedical Intensive Care Unit, Cardiological Institute, APHP Hôpital Pitié-Salpêtrière, 75013, Paris, France., QuenotJean-PierreJPMedical Intensive Care Unit, CHU Dijon Bourgogne, Dijon, France., Yacine Tandjaoui-Lambiotte, Jean-Francois Timsit, Antoine Vieillard-Baron, Auguste Dargent, Antoine Herault, and Matthieu Groh.
• Department of Internal Medicine, Foch Hospital, Suresnes, France. gaillet.antoine75@gmail.com.
• Intensive Care Med. 2023 Mar 1; 49 (3): 291301291-301.

PurposeAlthough eosinophil-induced manifestations can be life-threatening, studies focusing on the epidemiology and clinical manifestations of eosinophilia in the intensive care unit (ICU) are lacking.MethodsA retrospective, national, multicenter (14 centers) cohort study over 6 years of adult patients who presented with eosinophilia ≥ 1 × 109/L on two blood samples performed from the day before admission to the last day of an ICU stay.Results620 patients (0.9% of all ICU hospitalizations) were included: 40% with early eosinophilia (within the first 24 h of ICU admission, ICU-Eo1 group) and 56% with delayed (> 24 h after ICU admission, ICU-Eo2 group) eosinophilia. In ICU-Eo1, eosinophilia was mostly due to respiratory (14.9%) and hematological (25.8%) conditions, frequently symptomatic (58.1%, mainly respiratory and cardiovascular manifestations) requiring systemic corticosteroids in 32.2% of cases. In ICU-Eo2, eosinophil-related organ involvement was rare (25%), and eosinophilia was mostly drug-induced (46.8%). Survival rates at day 60 (D60) after ICU admission were 21.4% and 17.2% (p = 0.219) in ICU-Eo1 and ICU-Eo2 patients, respectively. For ICU-Eo1 patients, in multivariate analysis, risk factors for death at D60 were current immunosuppressant therapy at ICU admission, eosinophilia of onco-hematological origin and the use of vasopressors at ICU admission, whereas older age and the use of vasopressors or mechanical ventilation at the onset of eosinophilia were associated with a poorer prognosis for ICU-Eo2 patients.ConclusionEosinophilia ≥ 1 × 109/L is not uncommon in the ICU. According to the timing of eosinophilia, two subsets of patients requiring different etiological workups and management can be distinguished.© 2023. Springer-Verlag GmbH Germany, part of Springer Nature.

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