Systemic lupus erythematosus in the intensive care unit: a systematic review

Ana Suárez-Avellaneda, Jhon H Quintana, Cristian C Aragón, Linda M Gallego, Cindy-Natalia Gallego, Juan D Bolaños, Maria A Guerra, Maria Elena Ochoa, Marcela Granados, Ingrid Ruiz-Ordoñez, Gabriel J Tobón
Lupus 2020 July 28, : 961203320941941
Systemic lupus erythematosus (SLE) is an autoimmune disease with heterogeneous pathophysiologic mechanisms and diverse clinical manifestations. SLE is a frequent cause of intensive care unit (ICU) admissions. Multiple studies with controversial findings on the causes, evolution and outcomes of ICU-admitted patients with SLE have been published. The aim of this paper is to review the literature reporting the clinical characteristics and outcomes, such as mortality and associated factors, in such patients. Among the main causes of ICU admissions are SLE disease activity, respiratory failure, multi-organ failure and infections. The main factors associated with mortality are a high Acute Physiology and Chronic Health Evaluation (APACHE) score, the need for mechanical ventilation, and vasoactive and inotropic agent use. Reported mortality rates are 18.4%-78.5%. Therefore, it is important to evaluate SLE disease severity for optimizing clinical management and patient outcomes.

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