• Mabrouk Bahloul, Kais Regaieg, Mariem Dlela, Olfa Turki, Hana Nouri, Sabrine Bradaii, Ben Hamida Chokri C Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia. Fa, Bouaziz Nadia Khlaf NK Centre Intermédiaire, Rte El MATAR Km 4, Sfax, Tunisia., Imen Chabchoub, Sondes Haddar, Hedi Chelly, and Mounir Bouaziz.
• Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia.
• Clin Respir J. 2019 Aug 1; 13 (8): 513-520.

Purposeto evaluate the current rate of pulmonary embolism (PE) in our medico-surgical intensive care unit (ICU), to identify risk factors, and to determine the outcome of PE in ICU.MethodsWe performed a prospective cohort study of consecutive patients requiring intensive care admission during a one-year period. We included, in this prospective study, all the patients with confirmed PE admitted in ICU with more than 18 years of age, and expected to stay in ICU for more than 48 hours. Only the patients who had a clinical suspicion (unexplained hypoxemia and/or shock) for PE underwent diagnostic studies.ResultsDuring the study period, 842 patients were admitted in our ICU. One hundred and two patients were excluded. The diagnosis of PE was confirmed in 75 patients (10.1%). In our study, all patients (100%) had received some forms of pharmaceutical prophylaxis (PP) during ICU stay. The median time from ICU admission to diagnosis of PE was 6 days. The diagnosis of PE was made by spiral CT in 74 patients (98.7%), and by echocardiography in 1 case (1.3%). The mean ICU stay was 26.3 ± 26.5 days (median: 20 days). During their ICU stay, 73 patients (97.3%) developed one, or more, organ failure. Respiratory failure was the most observed (97.3%). Moreover, 38 patients (50.6%) developed nosocomial infections and 29 (38.6%) died. The multivariate analysis showed that the risk factors associated with mortality were the presence of shock the day of PE diagnosis and the presence of right ventricular dilatation on echocardiography.ConclusionOur findings confirm that subjects in the ICU are at high risk of PE, due to a high number of risk-factors. PE was associated with higher ICU mortality and a significantly higher ICU LOS. Our results invite to revise the preventive strategies of deep venous thrombosis and PE in patients requiring ICU admission.© 2019 John Wiley & Sons Ltd.

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