Prevalence and prognostic role of cardiovascular complications in patients with exacerbation of chronic obstructive pulmonary disease admitted to Italian respiratory intensive care units.

Patients admitted to respiratory intensive care units (RICUs) with exacerbation of chronic obstructive pulmonary disease (COPD) are at risk of cardiovascular comorbidities and/or cardiovascular complications (CVCs)1-8. Coexisting cardiovascular diseases (particularly coronary artery disease and left ventricular dysfunction)1,2,7,8, heartlung interactions during acute respiratory failure9-12 and cardiovascular effects of hypoxemia, hypercarbia, electrolyte imbalance, drug and physical therapy, mechanical ventilation, sleep-disordered breathing1-12 are possible causes of CVCs in these patients. Several CVCs such as cardiac arrhythmias, heart failure and cardiogenic shock require additional clinical and ECG monitoring and specific management. In recent years, European13 and Italian surveys14 have shown a growing interest in the organization of RICUs. In this study we have collected data from 11 of the 26 Italian RICUs involved in a large retrospective study in order to evaluate: a) the prevalence of CVCs in patients with exacerbation of COPD admitted to RICUs; b) which parameters detected at admission were predictive of CVCs; and c) the prognostic role of CVCs.