TY - JOUR T1 - Systemic Sclerosis and Outcome in Intensive Care Unit: Do Not Close the Door, Open the Right Protocol JF - The Journal of Rheumatology JO - J Rheumatol SP - 676 LP - 677 DO - 10.3899/jrheum.151057 VL - 43 IS - 3 AU - PAOLA FAVERIO AU - ALBERTO PESCI AU - ANTONIO M. ESQUINAS Y1 - 2016/03/01 UR - http://www.jrheum.org/content/43/3/676.abstract N2 - To the Editor:We read with great interest the paper by Pène, et al regarding the outcome of patients with systemic sclerosis (SSc) in the intensive care unit (ICU)1.The authors performed a retrospective single-center study on 41 patients with SSc admitted to the ICU in a 6-year period and evaluated the short-term and longterm mortality rates. Most patients had pulmonary involvement at baseline: pulmonary fibrosis on computed tomography scan in 71.7% of cases and severe reduction of forced vital capacity and DLCO in 42.4% and 85.7% of cases, respectively. When considering causes of ICU admission, acute respiratory failure (ARF) was the main reason (65.8%), with pulmonary infections accounting for 34.1% of cases, ARF without any definite diagnosis for 12.2% of cases, and drug-induced pneumonitis and pneumothorax, 1 case each. A noninvasive ventilation (NIV) trial was attempted in 13 patients (31.7%) and was successful in 8 cases, whereas 5 patients required endotracheal intubation. A total of 13 patients were intubated (31.7%), but only 2 of … Address correspondence to Dr. P. Faverio, Department of Health Science, University of Milan Bicocca, Clinica Pneumologica, AO San Gerardo, Via Pergolesi 33, Monza, Italy. E-mail: paola.faverio{at}gmail.com ER -