Article Contents
- 2023 (Vol.86)
- 2022 (Vol.85)
- 2021 (Vol.84)
- 2020 (Vol.83)
- 2019 (Vol.82)
- 2018 (Vol.81)
- 2017 (Vol.80)
- 2016 (Vol.79)
- 2015 (Vol.78)
- 2014 (Vol.76)
- 2013 (Vol.74)
- 2012 (Vol.72)
- 2011 (Vol.70)
- 2010 (Vol.68)
- 2009 (Vol.66)
- 2008 (Vol.64)
- 2007 (Vol.62)
- 2006 (Vol.60)
- 2005 (Vol.58)
- 2004 (Vol.56)
- 2003 (Vol.54)
- 2002 (Vol.52)
Analysis of Characteristics and Prognostic Factors in Adult Patients Receiving Mechanical Ventilation in the Medical Intensive Care Unit of a University Hospital
- Downloaded
- Viewed
Abstract
Background: Respiratory failure is a common condition that requires intensive care, and has a high mortality rate despite the recent improvements in respiratory care. Previous reports of patients with respiratory failure focused on the specific disease or included a large proportion of surgical patients. This study evaluated the clinical characteristics, outcomes and prognostic factors of adult patients receiving mechanical ventilation in a medical intensive care unit. Methods: Retrospective chart review was performed on 479 adult patients, who received mechanical ventilation for more than 48 hours in the medical ICU of one tertiary referral hospital. Results: The mean age of the patients was 60.3±15.6 years and 34.0% were female. The initial mean APACHEIII score was 72.3±25. The cause of MV included acute respiratory failure (71.8%), acute exacerbation of chronic pulmonary disease (20.9%), coma (5.6%), and neuromuscular disorders (1.7%). Pressure controlled ventilation was used as the initial ventilator mode in 67.8% of patients, and pressure support ventilation was used as the initial weaning mode in 83.6% of the patients. The overall mortality rate in the ICU and hospital was 49.3% and 55.4%, respectively. The main cause of death in hospital was septic shock (32.5%), respiratory failure (11.7%), and multiorgan failure (10.2%). Males, an APACHE III score ＞70, the cause of respiratory failure (interstitial lung disease, coma, aspiration, pneumonia, sepsis and hemoptysis), the total ventilation time, and length of stay in hospital were independently associated with mortality. Conclusion: The cause of respiratory failure, severity of the patients, and gender appears to be significantly associated with the outcome of mechanical ventilatory support in patients with respiratory failure
- keywords
- Respiratory failure, Mechanical ventilation, Outcome, Prognostic factor
Reference
Campbell EJ, (1965) Respiratory failure, Br Med J
Vincent JL, (2002) The epidemiology of acute respiratory failure in critically ill patients, Chest
Behrendt CE, (2000) Acute respiratory failure in the United States: incidence and 31-day survival, Chest
Esteban A, (2002) Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study, JAMA
Stauffer JL, (1993) Lynch JC, Goebel P. Survival following mechanical ventilation for acute respiratory failure in adult men, Chest
Vasilyev S, (1995) Hospital survival rates of patients with acute respiratory failure in modern respiratory intensive care units: an international, multicenter, prospective survey, Chest
Lewandowski K, (1995) Incidence, severity, and mortality of acute respiratory failure in Berlin, Germany, Am J Respir Crit Care Med
Luhr OR, (1999) Incidence and mortality after acute respiratory failure and acute respiratory distress syndrome in Sweden, Denmark, and Iceland. The ARF Study Group, Am J Respir Crit Care Med
Gillespie DJ, (1986) Clinical outcome of respiratory failure in patients requiring prolonged (greater than 24 hours) mechanical ventilation, Chest
The national survey of acute respiratory distress syndrome in Korea, (1997) Scientific Subcommittee for National Survey of Acute Respiratory Distress Syndrome in Korean Academy of Tuberculosis and Respiratory Disease, Tuberc Respir Dis
Chung HK, (1991) Clinical survey of patient in intensive care unit from March 1988 to February 1990 in Korea University Haewha Hospital, Korean J Crit Care Med
Kim JH, (1992) Clinical survey of patients in intensive care unit from March 1990 to February 1992 in Korea University Anam Hospital, Korean J Crit Care Med
Lee JA, (1996) Clinical surveys of patients in intensive care unit, Korean J Crit Care Med
Lee KN, (1991) Clinical survey of patients in the general intensive care unit, Korean J Anesthesiol
Hwang JH, (1991) Clinical survey of patients of intensive care unit, Korean J Anesthesiol
Shim YH, (1996) Clinical survey of ICU patients, Korean J Crit Care Med
Ki SS, (1996) Clinical surveys of patients in intensive care unit, Korean J Crit Care Med
Koh SO, (1983) Clinical survey of patients in the intensive care unit, Korean J Anesthesiol
Lee YW, (1988) Clinical survey of patients of the intensive care unit, Korean J Crit Care Med
Knaus WA, (1991) The APACHE III prognostic system: risk prediction of hospital mortality for critically ill hospitalized adults, Chest
Esteban A, (2000) How is mechanical ventilation employed in the intensive care unit? An international utilization review, Am J Respir Crit Care Med
Bone RC, (1992) Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis, Chest
Bernard GR, (1994) The American-European Consensus Conference on ARDS: definitions, mechanisms, relevant outcomes, and clinical trial coordination, Am J Respir Crit Care Med
Pauwels RA, (2001) Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary, Am J Respir Crit Care Med
Global strategy for asthma management and prevention,
Park JH, (2001) The prognosis of respiratory failure in patients with tuberculous destroyed lung, Int J Tuberc Lung Dis
Roupie E, (1999) Prevalence, etiologies and outcome of the acute respiratory distress syndrome among hypoxemic ventilated patients, Intensive Care Med
Zilberberg MD, (1998) Acute lung injury in the medical ICU: comorbid conditions, age, etiology, and hospital outcome, Am J Respir Crit Care Med
Schmidt CD, (1983) Prolonged mechanical ventilation for respiratory failure: a cost-benefit analysis, Crit Care Med
Epstein SK, (1999) Lack of influence of gender on outcomes of mechanically ventilated medical ICU patients, Chest
Kollef MH, (1997) The impact of gender on outcome from mechanical ventilation, Chest
Mallick S, (2008) Outcome of patients with idiopathic pulmonary fibrosis (IPF) ventilated in intensive care unit, Respir Med
Fernández-Pérez ER, (2008) Ventilator settings and outcome of respiratory failure in chronic interstitial lung disease, Chest
Cohen IL, (1995) Investigating the impact of age on outcome of mechanical ventilation using a population of 41,848 patients from a statewide database, Chest
Ely EW, (1999) Mechanical ventilation in a cohort of elderly patients admitted to an intensive care unit, Ann Intern Med
- Downloaded
- Viewed
- 0KCI Citations
- 0WOS Citations