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2017, Number 2

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Rev Cub Med Int Emerg 2017; 16 (2)

Risk factors of death in patients with invasive artificial mechanical ventilation

González AJC, Pupo JJM, Cabrera LJO

Language: Spanish
References: 10
Page: 109-120
PDF size: 593.53 Kb.


ABSTRACT

Introduction: clinical variables at the beginning of ventilation; typical from treatment and its complications are associated with death.
Objective: to identify and quantify the influence of different factors, hypothetically related to the evolution of patients, on the prognosis of patients with artificial mechanical ventilation.
Methods: a cohort trial was designed at the intensive care unit of “Carlos Manuel de Cespedes” General University Hospital in Bayamo, Granma, from June 1st, 2013 to December 31, 2015. We included 186 patients ventilated more than 48 hours.
Results: risk of dying was 4 times higher when there was circulatory shock (RR 4.2 95% CI 2.2-8.0 p = 0.00); it was doubled in the presence of co morbidities (RR 2.3 95% CI 1.2-4.3 p = 0.03) and increased 4-fold with failure of 2-4 organs (RR 4.1 95% CI 2.1 -8.1, p = 0.00). For the fraction of inspired oxygen (Fi02) › 0.47 the RR was 20.4 (95% CI 9.3-44.3, p = 0.00), acidosis 15.9 (95% CI 7.3 The use of inotropic drugs 15 (IC 95% 7.3-31.9, p = 0.00) and ventilator associated-pneumonia (VAP) 6 (IC) 95% 3.2-13.5, p = 0.03). FiO2, inotropic use, acidosis and VAP had an independent relationship with death in multivariate statistical analysis.
Conclusions: the fraction of inspired oxygen, the use of inotropic drugs, acidosis, and to acquire pneumonia during mechanical ventilation were the risk factors of death in patients with invasive artificial mechanical ventilation.


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