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Clinical Investigations in Critical CareOutcome of Patients Cared for in a Ventilator-Dependent Unit in a General Hospital
Section snippets
Organization of the Ventilator-Dependent Unit
The VDU is a self-contained area in the hospital with a dedicated medical and paramedical staff. A physician, approximately 14 nurses with expertise in and devotion to the care of patients with respiratory diseases, and a lead respiratory therapist are permanently assigned to the VDU. Additional personnel with shared responsibilities for other hospital services include pharmacists, respiratory therapists, physical and occupational therapists, dieticians, and a social worker. The unit takes a
RESULTS
The 67 females and 62 males who were admitted to the VDU had a mean age of 68±12 (SD) years, with a range of 24 to 90 years, and 65±14 years, with a range of 20 to 87 years, respectively. With the exception of two outpatients who accounted for three admissions, all patients had been cared for by other medical or surgical services of Saint Marys Hospital prior to admission to the VDU, although some patients who had been transferred to Saint Marys from other hospitals were already
DISCUSSION
There has never been and probably can never be a concurrent controlled study of patients treated in ventilator-dependent units and intensive care or other acute care hospital units. Therefore, we compared the outcomes of our VDU patients with those of a similar group of patients receiving long-term ventilation in the same hospital during a 29-month period from 1986 to 1988. Our experience with caring for ventilator-dependent patients in a VDU has been very rewarding. This report focuses on
ACKNOWLEDGMENTS
The authors wish to express their appreciation to David Hardy, RRT, VDU lead respiratory therapist, and the dedicated nurses of the VDU for making the VDU a success.
REFERENCES (10)
- et al.
Outcomes of patients admitted to a chronic ventilator-dependent unit in an acute-care hospital
Mayo Clinic Proc
(1992) - et al.
Hospital and post-hospital survival in patients mechanically ventilated for more than 29 days
Chest
(1992) - et al.
Clinical outcome of respiratory failure in patients requiring prolonged (>24 hours) mechanical ventilation
Chest
(1986) - et al.
Weaning from prolonged mechanical ventilation: the experience at a regional weaning center
Chest
(1994) - et al.
Interrupter mechanics of patients admitted to a chronic ventilator dependency unit
Am Rev Respir Dis
(1993)
Cited by (75)
Prolonged weaning: From the intensive care unit to home
2014, Revista Portuguesa de PneumologiaHow do older ventilated patients fare? A survival/functional analysis of 641 ventilations
2009, Journal of Critical CareCitation Excerpt :Over the last 2 decades, a large number of studies that assessed the outcome of mechanical ventilation have been published. A review of these articles points to 4 primary characteristics that they share: (a) most of these studies related only to patients who were ventilated in intensive care units (ICUs), ignoring all patients who were ventilated in other frameworks, usually medicine wards; (b) the age range of ventilated patients in those studies was usually very broad [6,8,10-13] and only a few included elderly patients exclusively; (c) the outcome measure was usually in-hospital mortality (or survival), and only some of them presented data on the functional state of the patients as well [3,7-9,12-15]; and (d) the outcome was usually measured at the end of hospitalization, and only in some cases [2-5,7,9,12-16] did the follow-up go beyond that point. In all the articles that were surveyed, there was no outcome study that related to all of the elderly patients (and only to them) who were ventilated in the hospital, their functional state, and the follow-up period after they were discharged from the hospital.
Predictors of successful weaning from prolonged mechanical ventilation in Taiwan
2009, Respiratory MedicineThe evolution of drug-resistant microorganisms in patients with prolonged mechanical ventilation
2009, American Journal of Infection ControlTransforming ICU Culture to Facilitate Early Mobility
2007, Critical Care ClinicsCitation Excerpt :Available literature suggests that interdisciplinary collaboration and a coordinated approach to management improves short-term quality and outcomes while reducing costs [6–11].
Supported by Health Care Financing Administration Demonstration Project Grant 29-P-99424/1.
Revision accepted May 26.
Reprint requests: Dr. Gracey, Mayo Clinic, Rochester, MN 55905