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Clinical features and outcomes of prolonged mechanical ventilation: a single-center retrospective observational study
BACKGROUND: Information on epidemiology of prolonged mechanical ventilation (PMV) patients in the acute care setting in Japan is totally lacking. We aimed to investigate clinical features, impact, and long-term outcomes of PMV patients. METHODS: This was a retrospective observational study conducted...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer Berlin Heidelberg
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6966730/ https://www.ncbi.nlm.nih.gov/pubmed/32026077 http://dx.doi.org/10.1186/s40981-019-0284-4 |
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author | Nagata, Isao Takei, Tetsuhiro Hatakeyama, Junji Toh, Masafumi Yamada, Hiroyuki Fujisawa, Michiko |
author_facet | Nagata, Isao Takei, Tetsuhiro Hatakeyama, Junji Toh, Masafumi Yamada, Hiroyuki Fujisawa, Michiko |
author_sort | Nagata, Isao |
collection | PubMed |
description | BACKGROUND: Information on epidemiology of prolonged mechanical ventilation (PMV) patients in the acute care setting in Japan is totally lacking. We aimed to investigate clinical features, impact, and long-term outcomes of PMV patients. METHODS: This was a retrospective observational study conducted in a tertiary care hospital. Adult patients who were admitted to our intensive care unit (ICU) from April 2009 to March 2014 and required mechanical ventilation (MV) for ≥ 2 days were included. PMV was defined as having MV for ≥ 21 consecutive days. RESULTS: Among 1282 MV patients, 93 (7.3%) required PMV, and median duration of MV was 37.0 days. Compared with the non-PMV patients, PMV patients had longer total ICU and high care unit (HCU) stay (34.0 vs. 7.0 days, p < 0.001), longer hospital stay (74.0 vs. 35.0 days, p < 0.001), and higher hospital mortality (54.8 vs. 21.4%, p < 0.001). In multivariable logistic regression analysis, emergency ICU admission and steroid use during MV were associated with PMV. The Kaplan–Meier curves for MV withdrawal and ICU/HCU discharge were almost identical. Among PMV patients, 52 (55.9%) died, 29 (31.2%) were successfully liberated from MV during hospitalization, and 12 (12.9%) still required MV at discharge. CONCLUSION: In this investigation, 7.3% of the patients with MV required PMV. Most PMV patients were liberated from MV during hospitalization, while occupying critical care beds for an extended period. A nationwide survey is required to further elucidate the overall picture of PMV patients and to discuss whether specialized weaning centers to treat PMV patients are required in Japan. |
format | Online Article Text |
id | pubmed-6966730 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-69667302020-02-04 Clinical features and outcomes of prolonged mechanical ventilation: a single-center retrospective observational study Nagata, Isao Takei, Tetsuhiro Hatakeyama, Junji Toh, Masafumi Yamada, Hiroyuki Fujisawa, Michiko JA Clin Rep Original Article BACKGROUND: Information on epidemiology of prolonged mechanical ventilation (PMV) patients in the acute care setting in Japan is totally lacking. We aimed to investigate clinical features, impact, and long-term outcomes of PMV patients. METHODS: This was a retrospective observational study conducted in a tertiary care hospital. Adult patients who were admitted to our intensive care unit (ICU) from April 2009 to March 2014 and required mechanical ventilation (MV) for ≥ 2 days were included. PMV was defined as having MV for ≥ 21 consecutive days. RESULTS: Among 1282 MV patients, 93 (7.3%) required PMV, and median duration of MV was 37.0 days. Compared with the non-PMV patients, PMV patients had longer total ICU and high care unit (HCU) stay (34.0 vs. 7.0 days, p < 0.001), longer hospital stay (74.0 vs. 35.0 days, p < 0.001), and higher hospital mortality (54.8 vs. 21.4%, p < 0.001). In multivariable logistic regression analysis, emergency ICU admission and steroid use during MV were associated with PMV. The Kaplan–Meier curves for MV withdrawal and ICU/HCU discharge were almost identical. Among PMV patients, 52 (55.9%) died, 29 (31.2%) were successfully liberated from MV during hospitalization, and 12 (12.9%) still required MV at discharge. CONCLUSION: In this investigation, 7.3% of the patients with MV required PMV. Most PMV patients were liberated from MV during hospitalization, while occupying critical care beds for an extended period. A nationwide survey is required to further elucidate the overall picture of PMV patients and to discuss whether specialized weaning centers to treat PMV patients are required in Japan. Springer Berlin Heidelberg 2019-11-04 /pmc/articles/PMC6966730/ /pubmed/32026077 http://dx.doi.org/10.1186/s40981-019-0284-4 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Article Nagata, Isao Takei, Tetsuhiro Hatakeyama, Junji Toh, Masafumi Yamada, Hiroyuki Fujisawa, Michiko Clinical features and outcomes of prolonged mechanical ventilation: a single-center retrospective observational study |
title | Clinical features and outcomes of prolonged mechanical ventilation: a single-center retrospective observational study |
title_full | Clinical features and outcomes of prolonged mechanical ventilation: a single-center retrospective observational study |
title_fullStr | Clinical features and outcomes of prolonged mechanical ventilation: a single-center retrospective observational study |
title_full_unstemmed | Clinical features and outcomes of prolonged mechanical ventilation: a single-center retrospective observational study |
title_short | Clinical features and outcomes of prolonged mechanical ventilation: a single-center retrospective observational study |
title_sort | clinical features and outcomes of prolonged mechanical ventilation: a single-center retrospective observational study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6966730/ https://www.ncbi.nlm.nih.gov/pubmed/32026077 http://dx.doi.org/10.1186/s40981-019-0284-4 |
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