Study of the characteristics and outcomes of patients on mechanical ventilation in the intensive care unit of EL-Mahalla Chest Hospital

• Published in: The Egyptian journal of chest diseases and tuberculosis 2015-07, Vol.64 (3), p.693-701
• Main Authors: Zamzam, Mohamed A., Abd El Aziz, Amal A., Elhefnawy, Maha Y., Shaheen, Nagia A.
• Format: Article
• Language: English
• Subjects: Invasive and noninvasive mechanical ventilation
• ISSN: 0422-7638
• DOI: 10.1016/j.ejcdt.2015.04.001

Improving the outcome of mechanically ventilated patients remains a mission we all strive to achieve. To provide baseline information for epidemiological trends, prognostic factors, and outcomes of patients on MV that will help planning of proper MV management programs. All adult patients received MV at EL-Mahalla Chest Hospital ICU between July 2013 and June 2014 were prospectively recruited. Different demographic, clinical and laboratory variables were recorded at the time of admission, during the ICU stay and at time of discharge. Out of the 412 patients admitted to the ICU, 130 patients received MV, either invasive MV (40%), noninvasive MV (50.7%) and 9.2% of the patients showed noninvasive failure and needed invasive ventilation. The commonest indication of MV was acute on top of chronic respiratory failure (77.7%). Chronic obstructive pulmonary disease was the most prevalent diagnosis (48.5%). Invasive MV was associated with low Glasgow coma scale, high APACHE II score, low admission PH, Po2 and high Pco2 higher morbidity and mortality rates compared to noninvasive MV. For an optimal discrimination of patients with highest risk of ICU mortality, a cutoff point of APACHE II score >30 showed sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 57.1, 88.1, 48, 91.4 and 0.73 respectively. At a cutoff point of GCC >30, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 71.4, 76.1, 36.6, 93.3 and 0.689 respectively. Survival among mechanically ventilated patients depended on the baseline characteristics at the start of MV, as well as on the development of complications and the management protocols in the ICU.