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Clinical Investigations in Critical CareIs the Duration of Mechanical Ventilation Predictable?
Section snippets
Materials and Methods
The study was conducted in a 12-bed surgical ICU (SICU) at a university hospital. Between November 1991 and December 1992, all patients requiring MV were included in the study. Patients requiring MV for cervical trauma, known subglottic or tracheal abnormality or chronic neuromuscular disease, and patients with noninvasive ventilation were not included. Patients were included only if intubation was performed in our SICU or in the operative room a few hours before SICU admission.
The following
Results
Over a 13-month period with 482 ICU admissions, 195 critically ill patients were studied: 123 male patients (63%), 72 female patients. Two hundred eighty-seven patients were not intubated and thus not included in the study. No patients met medical criteria for noninclusion (ie, neuromuscular disease). Two hundred three episodes of MV were analyzed (6 patients with two episodes and 1 patient with three). Mean age was 59.4±19.7 years (range, 14 to 96 years). The mean duration of endotracheal
Discussion
The first result of our prospective study is that various multiple factors and scores correlate with the duration of MV: serum albumin concentration, emergent endotracheal intubation, indication of MV, SS, LIS, OSFI, and SICU length of stay. The scores (SS, OSFI, LIS) are reliable for the duration of MV on the day of admission and on the day of intubation. However, only emergent endotracheal intubation and LIS on the day of intubation are statistically significant in the multivariate analysis.
Acknowledgment
The authors would like to thank Patricia Leriche for her manuscript assistance.
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2017, Journal of the Formosan Medical AssociationCitation Excerpt :Similarly, it is difficult to predict the need for PMV early in the course of critical illness. Although a number of predictors have been identified,19–21 the investigations are heterogeneous in the study population and the results cannot be extrapolated to the general critically ill population. In this regard, it is impractical to anticipate a trial on the issue we explored in this study.
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2015, Journal of Critical CareCitation Excerpt :An accurate objective tool to assist with this prediction would therefore be very useful but does not currently exist. Studies that aimed at developing such a tool have yielded models with low accuracy but have not accounted for early deaths [9–11]. Regarding this latter limitation, it is important to note that mechanical ventilation may be “not prolonged” when it is discontinued by means of clinical improvement and successful liberation, or alternatively by early death while it is still ongoing.
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