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What is the prognosis look like for a patient who...
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What is the prognosis look like for a patient who...

Hello....my aunt was admitted into an ICU over a week ago. She is a 48yr old type 1 diabetic with a history of smoking over a pack a day for at least 25yrs now. She is on a ventilator and recieving 100% O2. She has numerous ulcers on her legs now (I'm assuming from the lack of O2 in her lower extremities) and her pinky toe is black. She was positive for MRSA in her lungs. She had a chest tube placed that drained over 2liters of fluid immediatly upon placement. I was hoping once the fluid was removed she could slowly be weaned from the ventilator and we would begin to see some improvement. However, the fluid keeps coming back. I have not been able to be there to speak with the doctors or nurses about her condition so all I know is from other family members who are not in the medical field. I am just wondering what you think the prognosis for a patient in her condition would be. What are her chances of survival and if she does survive what will her quality of life be like? Thank you so much for taking the time to help me figure this out.
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There is a high mortality rate (>40% or more depending on other clinical circumstances, such as having Type 1 Diabetes and a heavy smoking history.  Being on a ventilator and having a large amount of fluid accumulate in one’s chest are other major risk factors.  The need for 100% oxygen is a bad prognostic sign.  I cannot quantify her chances for her survival but, with the information you have provided, I would surmise that her chance of survival is less than 50%.  According to that information, she has already been in the ICU for nearly two weeks.  The longer the need for ventilator support, the need for high concentration of oxygen and the rapid recurrence of fluid in your aunt’s chest, the likelihood of recovery will diminish.

If she survives, the quality of her life will be reduced but, how much, will be determined by how much irreversible lung damage has occurred.  Your family members, who are meeting with her doctor(s) should ask her doctors the same questions.

I wish that I could be more hopeful about her chances but I can’t, given the critical nature of her illness.

Good luck
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