Abstract

CABALLERO, H  and  UNIVERSIDAD NACIONAL DE ASUNCION. Unidad de Cuidados Intensivos de Adultos (UCIA) y 2 Primera Cátedra de Clínica Médica. Hospital de Clínicas. Facultad de Ciencias Médicas et al. Clinics features and complications in patients receiving mechanical ventilation in the adults intensive care unit of the Hospital de Clínicas. An. Fac. Cienc. Méd. (Asunción) [online]. 2012, vol.45, n.1, pp.45-54. ISSN 1816-8949.

ABSTRACT Objectives: to determine the frequency, clinical features, complications and factors associated with mortality of patients on mechanical ventilation. Materials and Methods: retrospective, descriptive with an analytical component of patients admitted to the Adult Intensive Care Unit of the Clinical Hospital, between January 2001 and May 2002. Clinical records were used and analyzed using Epi Info version 3.5.1., significant p <0.05. Results: Of 715 patients admitted, we evaluated 511 that required mechanical ventilation (71.5%). Most common indications for mechanical ventilation: postoperative 43.2% (n = 211), lung disease 23% (n = 117), neurological 7.4% (n = 38). Average duration of mechanical ventilation: 7.7 ± 9 days. Tracheostomy was performed in 7.6% (n = 39) of patients, more frequently indicated for prolonged intubation 40.6% (n = 13), on average on day 17; of these 87.1% (n = 34) were discharged with tracheostomy. Extubation failure: 10.4% (n = 53) and the most common causes were: poor secretions management and poor respiratory mechanics 17% (n = 9). Overall mortality was 52.6% (n = 269). Most common complications: pneumonia 31.7% (n = 53), mechanical complications related to the endotracheal tube 16.2% (n = 27), atelectasis 12% (n = 20), self-extubation 9% (n = 15), tracheostomy complications 7.8% (n = 13). Overall mortality in patients with complications related to mechanical ventilation was 49.7% (n = 83) and mortality attributable to complications of mechanical ventilation was 34.9% (n = 29). The complication most frequently associated with death was pneumonia (p = 0.03). Conclusion: use of mechanical ventilation is common, with significant associated complications, of which pneumonia is the main one and with the worst prognosis. Keywords: mechanical ventilation, complications, pneumonia.

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