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Fever, shortness of breath. Placed on ventilator, got cured. Chances of recovery?

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I have a cousin who was admitted to the hospital shortness of breath and a temperature. He seemed to improve and two days later was placed on a ventilator. He was shipped to a university center. His lungs were filled with fluid and was placed on Lasix. medication to elevate blood pressure, antibiotics and sedation. He is 68 years old, morbidly obese, diabetes, past coronary bypass and does not take care of himself. He was admitted to the university setting in cardiogenic shock with an ejection fraction of 10%. On admission they did a flu swab which came back positive for flu. The admitting hospital placed him on the ventilator. He has a living will which states he did not want CPR, Ventilator, Antibiotics,Surgery etc and no tube feedings. The university attending wanted a couple of days to get the fluid off his lungs. The fluid is gone, his blood pressure is still low 100/44 even on the medication and when the wanted to extubate him yesterday they were unable to because his O2 sats dropped into the 80's and he could not protect his airway. What is the probability of him having a realistic hope of significant recovery and have a quality of life. I was also told that if he did recover he may have 1 to 2 months. I do not believe considering his comorbidites that he will have a significant recovery, or quality of life.
Thank you, XXXXXXX
Posted Sat, 11 May 2013 in Hypertension and Heart Disease
Answered by Dr. Sukhvinder Singh 43 minutes later

Thanks for writing to us.

It is so unfortunate that your cousin has a dreadful disease. As per standard literature patients presenting with acute heart failure with an underlying low heart pumping (EF of ~10% as mentioned by you) has hospital mortality (death rate) of ~40% and further 30% of those being discharge alive will die in next several months. This will further worsen by presence of infection, need of intravenous drugs to maintain blood pressure, need of a ventilator, morbid obesity, low kidney functions and diabetes.

So definitely prognosis is not good in this case, but with a rider, statistics are not applicable to individual patients.

To make you understand------ for example, if we say a disease will kill 90% of the effected individuals in 1 month, then chances of survival of a given patient are low but no one knows if that particular patient is among 90% or among 10%. We can only guess by presence of various factors but can never be sure.

So overall, despite the fact that his chances of survival are low and looking at his comorbidities he may not have a good quality of life at all; but we can never be sure how the things will turn up for him.

I hope i made it as much clear to you as was feasible. feel free to discuss further.

sukhvinder XXXXXXX
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