TY - CHAP M1 - Book, Section TI - Rheumatologic and Inflammatory Conditions in the ICU A1 - Orsi, Deborah A1 - Correa-Lopez, Wilma A1 - Cavagnaro, John A2 - Oropello, John M. A2 - Pastores, Stephen M. A2 - Kvetan, Vladimir Y1 - 1 N1 - T2 - Critical Care AB - KEY POINTSICU mortality can be as high as 55% and can reach 79% in the systemic lupus erythematous (SLE) population.Severe sepsis and septic shock represent in fact the primary reason for ICU admission in about half of the rheumatologic patients.The clinical manifestations of autoimmune diseases itself can be very heterogeneous and virtually all organ systems can be affected.Most common adult rheumatologic disease encountered by the intensivist are in order of frequency, according to the most recent literature, SLE, rheumatoid arthritis (RA), systemic vasculitis, and systemic sclerosis (SS).Conditions associated with airway involvement include RA, granulomatosis with polyangiitis (GPA, former Wegener granulomatosis), relapsing polychondritis and SLE.Among all the rheumatologic diseases SS seems to have the highest prevalence (80%) of pulmonary involvement.Rheumatologic patients are at high risk of acute coronary syndromes due to premature atherosclerosis compared to age-match population.Renal involvement occurs in roughly 30% of the overall rheumatologic patients.Chronic steroids therapy used in the treatment of numerous rheumatologic conditions increase the risk of adrenal insufficiency in acutely critically ill patients.No clear prognosticator of in-ICU mortality has been identified as applicable to single patient yet, but intuitively high Apache score, multiorgan failure, comorbidities, advanced age and pancytopenia were all associated with worse outcome. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1136415920 ER -