Esperienza di una terapia intensiva intermedia respiratoria nel trattamento di prolungati svezzamenti dalla protesi ventilatoria meccanica.

Translated title of the contribution: Experience of an intermediate respiratory intensive therapy in the treatment of prolonged weaning from mechanical ventilation

M. Vitacca, E. Clini, R. Porta, D. Sereni, N. Ambrosino

Research output: Contribution to journalArticlepeer-review

Abstract

109 patients who suffered from an episode of acute respiratory failure, necessitated mechanical ventilation (MV) in a general Intensive Care Unit (ICU) and admitted to our Respiratory Intermediate Intensive Unit (RIIU), were retrospectively evaluated for outcome and weaning success. The patients, 69 +/- 9 years old, presented the following diseases: COLD (70%), cardiovascular (15%) and neuromuscular (15%). A relapse of underlying disease (62%), pneumonia (20%), thoraco-muscular pump failure (15%) and pulmonary embolism (3%) were the relapsing causes needing the ICU admission. Patients remained intubated for 12 +/- 6 days and ventilated for 25 +/- 10 days. They were transferred to RIIU on pressure support ventilation (70%); the causes of prolonged and/or difficult weaning were as following: lung failure (48%), pump failure (12%), cardiac and haemodynamic instability (28%) others (12%). Apache II score was 18 +/- 5. Maximal inspiratory pressure (31 +/- 7 cmH2O) and respiratory rate/tidal volume (83 +/- 34) were measured within 48 hours after RIIU admission. 82 subjects (75%) were weaned after 6 +/- 4 days of MV using in 87% of patients pressure support technique with spontaneous breathing cycles with oxygen supplementation. 8 patients on 109 (7%) died; 20 patients on 109 (18%) were discharged after 40 +/- 9 days of stay in RIIU necessitating home MV more than 18 hours/day by means of a tracheostomy. All patients stay in RIIU for 17 +/- 7 days with a mean cost per die of 750 thousands lire. Our data suggest that a RIIU institution for prolonged weaning in chronic diseases may be a useful solution to decrease superfluous stays in ICU decreasing costs without ba worsening in quality of care.

Translated title of the contributionExperience of an intermediate respiratory intensive therapy in the treatment of prolonged weaning from mechanical ventilation
Original languageItalian
Pages (from-to)57-64
Number of pages8
JournalMinerva Anestesiologica
Volume62
Issue number3
Publication statusPublished - Mar 1996

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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