Volume 5 Supplement 3

First International Symposium on Intensive Care and Emergency Medicine for Latin America:

Open Access

MODS in mechanically ventilated patients

  • JAB Froemming1,
  • MO Guerreiro1,
  • D Oliveira1,
  • N Almeida1 and
  • FS Dias1
Critical Care20015(Suppl 3):P56

DOI: 10.1186/cc1389

Published: 26 June 2001

Introduction

The need of mechanical ventilation (MV) lead to augment of nosocomial infections and sepsis, length of stay in ICU, as well as MODS. Our purpose was to stratify and correlate the occurrence of MODS with mortality in patients on MV using a specific score.

Methods

This is a retrospective analysis of all patients in the ICU who were on MV between January 1999 and December 2000. Data collected was age, gender, APACHEII score and length of stay (LOS) in ICU. Criteria for MODS were those proposed by Marshall et al. Patients were divided in survivors (SV) and nonsurvivors (NSV) accordingly to ICU survival. The differences between groups were analyzed with t-test, Χ2 and Mann-Whitney as indicated.

Results

During the study period there were 903 admissions, of whom 621 (68%) recquired MV. Mean age was 51.5 ± 18.9 (SV) and 61 ± 17.1 years (NSV; P < 0.0001), 328 (52.8%) were male (NS), and APACHEII was 12.6 ± 6 versus 19.3 ± 7.8 (P < 0.0001) in SV and NSV, respectively. The LOS in ICU was 15 ± 14.6 and 9.6 ± 11.6 days in SV and NSV (P < 0.0001). The results of the MODS in SV and NSV are shown in the Table. Six patients were excluded from this analysis due to lack of data.

Table

  

Day

MODS

 

1

2

3

4

5

6

7

 

n

615

585

531

481

438

390

347

Total

SV

3.5 ± 2.8*

3.5 ± 2.5*

3.7 ± 2.6*

3.6 ± 2.5*

3.5 ± 2.5*

3.3 ± 2.3*

3.4 ± 2.5*

 

NSV

5.8 ± 3.6

6 ± 3.4

6.4 ± 3.6

6.7 ± 3.5

7.1 ± 3.7

6.9 ± 3.5

6.7 ± 3.5

CNS

SV

0.6 ± 1.2

0.5 ± 1.2

0.5 ± 1.1

0.6 ± 1.2

0.7 ± 1.3

0.8 ± 1.3

0.7 ± 1.3

 

NSV

0.6 ± 1.3

0.5 ± 1.2

0.6 ± 1.2

0.6 ± 1.3

0.7 ± 1.4

0.7 ± 1.3

0.6 ± 1.3

Cardiovascular

SV

0.8 ± 1.1†

0.9 ± 1.1*

1 ± 1.1*

0.9 ± 1.1*

0.8 ± 1*

0.7 ± 0.9*

0.7 ± 0.9*

 

NSV

1.3 ± 1.5

1.3 ± 1.3

1.4 ± 1.3

1.4 ± 1.3

1.6 ± 1.4

1.5 ± 1.3

1.5 ± 1.3

Pulmonary

SV

1.2 ± 1.2*

1.1 ± 1.1*

1.1 ± 1.1*

1.1 ± 1.1*

1 ± 1*

0.9 ± 1*

1.1 ± 1.1*

 

NSV

1.6 ± 1.4

1.6 ± 1.3

1.7 ± 1.2

1.8 ± 1.2

1.8 ± 1.3

1.9 ± 1.2

1.8 ± 1.2

Renal

SV

0.4 ± 0.8*

0.4 ± 0.8*

0.4 ± 0.8*

0.3 ± 0.7*

0.4 ± 1.1*

0.2± 0.6*

0.3 ± 0.6*

 

NSV

0.9 ± 1.1

0.9 ± 1.1

0.9 ± 1.6

0.9 ± 1

0.9 ± 1

0.9 ± 1

0.9 ± 1.1

Hematologic

SV

0.3 ± 0.8*

0.4 ± 0.8*

0.4 ± 0.8*

0.4 ± 0.8*

0.4 ± 0.8*

0.3 ± 0.7*

0.3 ± 0.8*

 

NSV

0.9 ± 1.3

1 ± 1.4

1.1 ± 1.4

1.2 ± 1.4

1.3 ± 1.5

1.1 ± 1.4

1.1 ± 1.4

Hepatic

SV

0.3 ± 0.6

0.3 ± 0.6*

0.3 ± 0.7*

0.3 ± 0.6*

0.3 ± 0.6*

0.3 ± 0.6*

0.3 ± 0.6*

 

NSV

0.5 ± 1

0.6 ± 0.1

0.7 ± 1.1

0.7 ± 1.1

0.7 ± 1.1

0.7 ± 1.1

0.8 ± 1.1

*P < 0.0001; P < 0.001.

Conclusions

Nonsurvivors of mechanical ventilation had higher scores of MODS than SV and also higher individual organ system scores, although severe individual organ dysfunction was not present. Age and APACHEII score at admission also were associated with mortality.

Authors’ Affiliations

(1)
Hospital São Lucas da PUCRS

Copyright

© The Author(s) 2001

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