(15,16) Data were collected consecutively from all intubated patients (pediatric and adult) who had been admitted to the ICU and required
mechanical ventilation for more than 24 consecutive hours during the study period; therefore, we included all eligible patients in this study who met the study inclusion criteria.
Additionally, the groups differed in age, length of stay in the intensive care unit (ICU) and duration of
mechanical ventilation, all of which may impact negatively on weaning/extubation outcome.
These critical patients on
mechanical ventilation, require team work, knowledge of caregoals, and interventions based on best practices, patient needs, and response to therapy.
Socio-demographic as well as clinical details of the cases included in the study were recorded using a semi-structured proforma which contained the details like age, gender, immunisation status, weight, admitting diagnosis, presence of chronic disease and immunosuppression, reason for
mechanical ventilation, duration of ventilation and PICU stay, ventilator settings, complications, outcome including mortality were recorded.
The multivariate logistic regression analysis revealed that all the age > 65 years (OR= 3.350, 95% CI = 1.936-5.796, P [less than or equal to] 0.001), smoke (OR= 3.206, 95% CI = 1.9095.385, P [less than or equal to] 0.001), coronary heart disease (OR= 3.179, 95% CI = 1.015-4.130, P = 0.017), diabetes (OR = 5.042, 95% CI = 3.518-7.342, P [less than or equal to] 0.001), COPD (OR= 1.942, 95% CI = 1.258- 2.843, P = 0.012), ICU and hospital stay (OR = 2.34, 95% CI = 1.145-3.892, P = 0.038), and days on
mechanical ventilation (OR = 1.992, 95% CI = 1.107-3.287, P = 0.007) are independent risk factors of VAP (Table 2).
Thus, this parameter could be used at bedside to stratify patients when deciding to treat patients with NPPV or in deciding to terminate NPPV and proceed to invasive
mechanical ventilation.
Humidity results in Table 2 show that both groups had a reduction in moisture levels, but that the decrease was much greater and statistically significant with
mechanical ventilation. In homes without
mechanical ventilation, the reduction did not achieve statistical significance.
A 38-year-old female smoker arrived with bilateral infiltrates and severe hypoxic respiratory failure needing
mechanical ventilation. An iatrogenic pneumothorax developed that required chest tube placement.
Mechanical ventilation time, oxygen therapy time and length of hospital stay:
Mechanical ventilation time, oxygen therapy time and length of hospital stay of newborns in the research group were shorter than those of newborns in the control group, and the differences had statistical significance (P0.05).
"The increased focus on safe ventilator initiation and management that will result from the publication of this white paper will help ensure more facilities take a hard look at the competencies held by clinicians who are allowed to manage
mechanical ventilation. As the most well trained clinicians in ventilator care, that bodes well for RTs, and most importantly, the ventilator patients who rely on their care."
Srikanth Venkataraman, senior analyst for GBI Research, said: "The already high prevalence of COPD will be exacerbated by the aging population, leading to more critical care admissions, where the use of
mechanical ventilation is common.
A study of 67,651 ED visits for AECOPD found NIV use, compared with invasive
mechanical ventilation, was associated with reduced inpatient mortality of 46%, shortened hospital length of stay by 3 days, reduced hospital charges of approximately $35,000 per visit, and modestly reduced risk of iatrogenic pneumothorax.