A 5-year registry of mechanically ventilated patients comprising epidemiology, initial settings, and clinical outcome

Abstract

Introduction Our primary aim was to document our interactions with patients subjected to mechanical ventilation (MV) in the Critical Care Department focusing on epidemiological characteristics; the initial modes of ventilation used, and initial settings. Our secondary aim was to document final clinical outcomes of MV, including length of stay, weaning, complications, and hospital mortality. Patients and methods Patients’ data were collected retrospectively from January 2010 to December 2014 (5 years) through reviewing an electronic database (Medica Plus). Results We enrolled a total of 1081 patients. The duration of ventilation was 6±10 days, and length of ICU stay was 13±15 days. The predominant indications of ventilation were cardiac diseases followed by respiratory diseases, neurological diseases, sepsis, and septic shock. Volume controlled ventilation was the most common initial mode of ventilation followed by Non Invasive Continuous Positive Airway Pressure – Pressure Support (NICPAP-PS) and pressure controlled ventilation. Noninvasive ventilation was associated with shorter duration on MV and ICU stay. Pressure Support – Continuous Positive Airway Pressure (PS-CPAP) was the most common weaning mode used followed by unplanned extubation, Non Invasive Continuous Positive Airway Pressure (NICPAP), T-piece, and sencronized intermittent mandatory ventilation. Highest rate of successful weaning was in patients with central nervous system diseases followed by respiratory diseases, cardiac diseases, and least in patients with sepsis and septic shock. Mortality rate in mechanically ventilated patients was 64%. Mortality rate was higher in patients with cardiac diseases followed by respiratory diseases, central nervous system diseases, and septic shock. Mortality was higher with higher levels of tidal volumes, higher FiO2 levels, and lower positive end-expiratory pressure levels. Mortality was higher in invasive ventilation than noninvasive ventilation. Patients with failed weaning had higher mortality. Conclusions We have demonstrated the magnitude of MV use in our ICU, the epidemiology and initial ventilation modes used, and their association with complications and in-hospital mortality.