How to care for people with Parkinson’s disease in the Intensive Care Unit?

Maladie de Parkinson – les particularités en Réanimation

Abstract

Second most common cause of neuroprogressive disorder after Alzheimer’s disease and in full epidemiological leap (twice as many people affected in 2035-2040), Parkinson’s disease stands out from its very long evolution and its range of available treatments (from oral levodopa to deep brain stimulation). Unlike other neuroprogressive disorders, people with Parkinson’s disease (PPD) are admitted to intensive care units with higher severity scores, have a longer length of stay, but the mortality is not significantly different from the general patient population. In this update, we will try to explain this apparent paradox, based on epidemiological data, while emphasizing the clinical prognostic factors and the management of the disease (pharmacological and surgical treatmentsl). The second part wil address in detail the particularities of PPD in an intensive care unit: falls, airway management (intubation, extubation, non-invasive ventilation), general anesthesia, visual hallucinations and delirium as well as dysautonomia (hypotension and Olgivie syndrome).