Respiratory insufficiency: a proposal of a databank

Introduction

Respiratory insufficiency is a common cause of ICU admission. In order to evaluate causes and mortality, a consecutive series of 44 patients were studied at the ICU of Santa Lucia Hospital, according to a protocol applied to collect data.

Materials and methods

From 6 November 2004 to 11 January 2005, 44 consecutive patients were admitted to the ICU of Santa Lucia Hospital with respiratory insufficiency. Data were collected prospectively through a specific protocol for all patients that needed invasive or non-invasive ventilatory support.

Results

The mean age was 69.6 years, and 25 (56.8%) were women. The mean body mass index was 26.7 kg/m². The most common causes were lack of consciousness (25%) and pneumonia (20.4%). The clinical symptoms most observed were low pulse oxymetry (75%) and dyspnea (65.9%). A total 65.1% needed tracheal intubation (TI) and mechanical ventilation on admission. Another 31.8% used non-invasive mechanical ventilation (NIMV). As regards ventilatory mode used, 67.4% had the assisted/controlled mode. Twenty-five percent of the patients developed pneumonia after mechanical ventilation. The mechanical ventilation mean time was 164.7 hours. Eight subjects needed a tracheostomy with an average 8.5 days of TI. The mean ICU stay was 10.3 days. The mortality rate was 45.4%.

Conclusion

Respiratory insufficiency is a very serious and frequent clinical condition in the ICU, with a high mortality rate. NIMV avoided tracheal intubation in 31.8% of patients.