Weaning of mechanical ventilation in the intensive care units of Brazil

Introduction

The discontinuation of mechanical ventilation represents an important stage for patients in mechanical ventilation in the ICU, and knowing how this procedure is being managed make us better intensivist physicians. Our purpose in this study was to determine some aspects of the patients that were being weaned from mechanical ventilation in Brazil.

Methods

A study of 1 day prevalence was done in 34 ICUs of Brazil. In the questionaire answered by the ICUs, we present here the modes of ventilation used in the weaning stage, the diseases that were the reason for the indication of mechanical ventilation, and some aspects about the patients with ventilator-associated pneumonia (VAP).

Results

The study evaluated 390 patients, with 215 patients being in some kind of ventilatory support. Sixty-nine patients (69/215) were in discontinuation of mechanical ventilation. The patients were distributed as: PSV, 48 (48/69); SIMV + PSV, nine (9/69); spontaneous, four (4/69); SIMV, three (3/69); PCV, three (3/69); and VCV, two (2/69). The causes of admission in mechanical ventilation of this group were COPD (1/69), neuromuscular disease (2/69), coma (9/69), and acute respiratory failure (57/69). On the day of the study, 38 patients were with pneumonia (38/69): 20 were with VAP, 11 were with nosocomial pneumonia and seven were with community pneumonia. The medium times of mechanical ventilation were, respectively, 39.2 days, 23.7 days and 8.3 days.

Conclusion

About 32% of the patients in mechanical ventilation were being discontinued. PSV was the principal mode used, while acute respiratory failure was the main cause of mechanical ventilation's use. The incidence of VAP was 29%, and it was related with the long median time of mechanical ventilation.