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Mechanical ventilation profile in an adult ICU in Brazil

Background

Adult critically ill patients need invasive mechanical ventilation support due to distinct causes that vary from an elective high-risk surgery to post cardiorespiratory arrest.

Objective

To know the mechanical ventilation profile in an adult medical-surgical ICU in Brazil. To study adults patients that needed more than 24 hours invasive mechanical ventilation support in an adult ICU in Brazil.

Methods

We analyzed all patients that needed more than 24 hours invasive mechanical ventilatory support admitted to Albert Einstein Adult medical-surgical 36-bed ICU from December 2008 to April 2010. We studied patient's age, sex, APACHE II score, cause of intubation/mechanical ventilation, duration of ventilatory support, maximum inspiratory pressure (MIP; mmHg), maximum expiratory pressure (MEP; mmHg) and respiratory shallow breathing index (RSBI; l), rate of extubation success and ratio of reintubation.

Results

A total of 252 patients were studied, mean age 63 ± 19 years, 35% females, mean APACHE II score 22 ± 6. The main cause of intubation/mechanical ventilation was acute hypoxemic respiratory failure (35%) followed by depressed level of consciousness (34%), post high-risk surgery (19%), airway obstruction (3%), hemodynamic instability (5%) and respiratory fatigue (01%). The mean duration of invasive mechanical ventilation was 114 ± 4 hours (27 to 566 hours). Before a spontaneous breathing trial to check readiness for extubation, mean MIP was 48 ± 12 (20 to 120) mmHg, mean MEP was 45 ± 15 (12 to 120) mmHg and mean RR/TV (l) was 53 ± 20 (5 to 190). The extubation success rate was 87.3%. We used non-invasive ventilation immediately after extubation in 66% of our patients. In total, 12.7% patients needed reintubation. The hospital mortality rate was 8.75% (22 patients). There were no differences in regard to age, gender, mechanical ventilation time, MIP, MEP, RSBI, use of non-invasive mechanical ventilation and reintubation rate between patients that survived and those that died.

Conclusion

In our ICU the main causes for invasive mechanical ventilatory support were hypoxemic respiratory failure and post high-risk surgery. The mean duration of invasive support was 4.7 days and the reintubation rate was 12.7%.

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Correspondence to CSV Barbas.

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Barbas, C., Saghabi, C., Taniguchi, C. et al. Mechanical ventilation profile in an adult ICU in Brazil. Crit Care 15, P40 (2011). https://doi.org/10.1186/cc10188

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Keywords

  • Mechanical Ventilation
  • Invasive Mechanical Ventilation
  • Spontaneous Breathing Trial
  • Maximum Inspiratory Pressure
  • Cardiorespiratory Arrest