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2006, Number 4

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Med Crit 2006; 20 (4)

Long-term assisted mechanical ventilation in the intensive care unit: definition, causes and prognosis

Cerda GP, Olvera GC, Aguirre SJ, Franco GJ, Elizalde GJ, Martínez SJ

Language: Spanish
References: 26
Page: 157-163
PDF size: 76.43 Kb.


ABSTRACT

Objectives: Identify the causes of long term mechanical ventilation (LTMV) in the ICU and characterize its outcome.
Design: Prospective and observational.
Setting: ICU of a 3rd level hospital.
Interventions: None.
Methods and results: 39 patients with LTMV (mean age 59.4 %#177; 26) were grouped in: patients with acute respiratory failure with previously healthy lungs (group I), and with previous chronic lung disease (group II). The following variables were obtained: Demographics, APACHE II score, length of mechanical ventilation, necessity of tracheostomy and time of realization, management with non invasive mechanical ventilation (NIMV) after extubation, discharge with or without mechanical ventilation (MV), mortality, length of stay and outcome, 28 days after being discharged. Group I patients required less NIMV (27% vs 54%, p ‹ 0.01), better success in removing from MV (58% vs 0%, IC 95% 0.1-1, p ‹ 0.001), less hospital mortality (31% vs 75%, IC 95%, 1.3-5, p ‹ 0.01) and better survival 28 days after discharge (62% vs 0%, p ‹ 0.01). There were no other significant differences.
Conclusions: LTMV in patients with chronic lung disease must be evaluated and it may be not justified and it did not reduce short or long term mortality.


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