Mechanical ventilation in toxic epidermal necrolysis

• Published in: Handchirurgie, Mikrochirurgie, plastische Chirurgie Vol. 43; no. 2; p. 125
• Main Authors: Namdar, T, Stang, F H, Siemers, F, Stollwerck, P L, Wild, T von, Mailänder, P, Lange, T
• Format: Journal Article
• Language: German
• Published: Germany 01.04.2011
• Subjects: Adult; Aged; Continuous Positive Airway Pressure; Erythema Multiforme - mortality; Erythema Multiforme - therapy; Female; Hospital Mortality; Humans; Intensive Care Units; Kaplan-Meier Estimate; Male; Middle Aged; Retrospective Studies; Stevens-Johnson Syndrome - mortality; Stevens-Johnson Syndrome - therapy; Survival Rate
• ISSN: 1439-3980
• DOI: 10.1055/s-0030-1263110

Toxic epidermal necrolysis (TEN) is associated with a high mortality. The need for mechanical ventilation is associated with an increased mortality in TEN patients. This study investigates the impact of the timing of initiation of the mechanical ventilation on the survival of TEN patients. A retrospective study of 26 TEN patients was carried out. Primary (on admission (group A) and secondary ventilation (>1 day after admission (group B) were analysed for an association with mortality. 8 patients did not require mechanical ventilation. 18 patients needed mechanical ventilation. In group A 8 patients with an epidermolytic body surface area (BSA) of 73 ± 16% and a mean SCORTEN of 3.2 ± 1.1 were analysed. In group B 10 patients with an epidermolytic BSA of 76 ± 19% and a mean SCORTEN of 3.8 ± 0.9 were evaluated. Statistical analysis showed an increased mortality in all mechanically ventilated compared with non-ventilated TEN patients (Odds ratio: 2.0; 95% CI: 1.26-3.17 p = 0.013). Mechanical ventilation in TEN patients is associated with an increased mortality rate, but the timing of initiation of mechanical ventilation does not affect the patient survival rates.