Document Type : Original Article

Authors

1 Department of Anesthesiology and Critical Care, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran

2 Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran

3 Chemical Injuries Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran

4 Department of Anesthesiology and Critical Care, Khatamolanbia Hospital, Zahedan University of Medical Sciences, Zahedan, Iran

Abstract

Background: Endotracheal intubation (EI) associated with mechanical ventilation (MV) is frequently performed in critical ill patients admitted in ICU with sepsis.
Methods: Adult patients admitted in the mixed medical–surgical ICUs with sepsis at the ICU admission who needs prolonged mechanical ventilation (PMV) (≥ 21 days) were included in this retrospective secondary analysis study. The primary outcome was the ICU mortality. Baseline demographic and clinical characteristics of all patients were assessed as risk factors associated with duration of MV by univariate and multivariate Binary Logistic regression.
Results: Among patients with sepsis at ICU admission, 85 patients requiring more than 21 days of MV. Out of the 85 patients, 52 (61.2%) patients were intubated within 30 to 34.50 days and 33 (38.8%) patients had intubation within 34.51 to 65 days, and categorized as PMV and very prolonged MV groups, respectively. According to the adjusted model, two parameters were significantly associated with very prolonged MV which as follows by older age 1.229 (95% CI: 1.002-1.507, P=0.048) and long hospital LOS 2.996 (95% CI: 1.676-5.356, p <0.001). In addition, no significant survival difference was observed between two groups of study. (33.3% vs. 25%, P=0.406).
Conclusion: Our observations showed that the older age and long hospital LOS as pre-ICU stay in patients with positive sepsis at the ICU admission can prolong the duration of intubation. In addition, no significant survival difference was observed between patients with PMV and very prolonged MV.

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