Analysis of Characteristics and Prognostic Factors in Adult Patients Receiving Mechanical Ventilation in the Medical Intensive Care Unit of a University Hospital.
10.4046/trd.2008.65.4.292
- Author:
Jin Woo SONG
1
;
Chang Min CHOI
;
Sang Bum HONG
;
Yeon Mok OH
;
Tae Sun SHIM
;
Chae Man LIM
;
Sang Do LEE
;
Woo Sung KIM
;
Dong Soon KIM
;
Won Dong KIM
;
Younsuck KOH
Author Information
1. Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. yskoh@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Respiratory failure;
Mechanical ventilation;
Outcome;
Prognostic factor
- MeSH:
Adult;
APACHE;
Cause of Death;
Coma;
Female;
Humans;
Critical Care;
Intensive Care Units;
Length of Stay;
Lung Diseases;
Male;
Pneumonia;
Respiration, Artificial;
Respiratory Insufficiency;
Retrospective Studies;
Sepsis;
Shock, Septic;
Tertiary Care Centers;
Ventilation;
Ventilators, Mechanical;
Weaning
- From:Tuberculosis and Respiratory Diseases
2008;65(4):292-300
- CountryRepublic of Korea
- Language:Korean
-
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 APACHE III 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.
