Characteristics, outcome of patients on invasive mechanical ventilation: A single center experience from central India

Abstract

Introduction

The information on patient characteristics and outcome in patients requiring invasive mechanical ventilation (IMV) is critical for better use of resources and clinical decision making in a rural ICU.

Objective

To understand characteristics and outcome of patients on IMV.

Design

This is a retrospective study in patients admitted in medical intensive care unit of a rural hospital who were on IMV during August 2013 to February 2015. Adult patients with failing respiratory drive and/or those who failed oxygen therapy or NIV (non invasive ventilation) were considered eligible for invasive ventilation. Patients exclusively on NIV were excluded (reason for exclusion was to study the outcome in an expensive intervention like IMV). Patients who were weaned and extubated and subsequently shifted to medicine ward were considered “good” outcome and “adverse” (not-extubated) if they died or sought discharge against medical advice.

Outcome measure

All-cause mortality during ICU stay.

Results

A total of 505 patients, of which 74.7% were male with mean age of 52 years (IQ range 38–65 years). Comorbidities were seen in 76.4% patients; significantly higher in not-extubated (94.85% vs 5.15%) (p = 0.008). The ICU stay, days on ventilation and total hospital stay were 5 (3–9) days, 2 (1–5) days and 5(3–9) days respectively. Primary cause for IMV was sepsis, neurological, cardiac, renal and respiratory and others like envenomation, drug overdose, organophosphate poisoning, etc. Hypertension and diabetes were the commonest co-morbidities.

Conclusion

The mortality in patients requiring invasive ventilation support from low-resource setting is high.