Background: Mechanical ventilation plays an important role in the management of critically ill patients with respiratory failure. However, survival among ventilated patients depends on the primary disease and its management. Aims: To study the clinical profile, outcome and complications in critically ill patients on invasive mechanical ventilators admitted in the MICU. Methods: A prospective study was carried out in SSG Hospital, Vadodara from 2nd July 2011 to 5th December 2012 and 155 adult patients aged >12 years requiring IMV >48hours were enrolled. Detailed history, clinical examination, and Investigations were carried out and patients were followed up until discharge or death. Pre-intubation Sequential Organ Failure Assessment (SOFA) score and Arterial Blood Gas analysis (ABGA) were done and repeated on follow-up. Results: According to this study, 67% of the patients (104/155) belonged to the most productive age (15-44) group. However, the least mortality (17.86%) was noted in 15-29 age group. Mortality rates were higher in older age groups (50% in both 40-59years and 65+ years). Organophosphorus (OP) poisoning was the major indication for IMV (105/155 patients) but was associated with lower mortality rates (26.67%). A higher mortality rate of 41.17% was noted in ARDS group. Pre-ventilation SOFA scores had high sensitivity in predicting mortality in OP cases. Score >7 had a poor prognosis. However, there was no role of SOFA score in Malarial ARDS as thrombocytopenia was observed. Higher complications were seen in patients requiring IMV >7days (39.6% had Vocal cord edema and 28.30% has VAP). Conclusion: Early diagnosis and management of primary disorders leading to respiratory failure prevents the complications and improves the outcome of the patient. The goal of IVM therapy is to overcome the crisis and once it is resolved, early weaning prevents further complications.
Shastri Minal, Dr. Varsha Patel, Pandya Karan, Banker Sachi, Dhrangdhariya Aashish. Clinical profile and outcome in critically ill patients with respiratory failure on invasive mechanical ventilator. International Journal of Medicine Research, Volume 3, Issue 4, 2018, Pages 25-30