INTRODUCTION:In mainland China, there are no special care centers (long-term acute care, weaning, chronic care facilities) for patients requiring prolonged mechanical ventilation (PMV). Our goal was to characterize the prevalence and outcome of patients undergoing PMV in Chinese intensive care units (ICUs). METHODS: A prospective 1-d prevalence study was performed at 55 ICUs, with 28-d follow-up. RESULTS: On the observation day, 622 adult patients occupied ICU beds. Enrollment criteria were met by 302 subjects receiving invasive mechanical ventilation, of which 109 (36.1%) had received ventilation for more than 21 d (median 51, 21-3,419), which was defined as PMV. During the following 28 d, another 45 subjects were classified as receiving PMV, but only 5% (3/58) of the subjects who were newly admitted to the ICU on the study day received PMV. Thirty-six (22.9%) of the 157 subjects receiving PMV were weaned, and 81 (51.6%) continued ventilation in the ICU. In the logistic regression analysis, age >74 y (odds ratio ‫؍‬ 2.78, 95% CI 1.05-7.40, P ‫؍‬ .041) and chronic congestive heart failure (odds ratio ‫,32.21؍‬ 95% CI 1.48 -101.05, P ‫؍‬ .020) were associated with failure to wean in 28 d, while acute respiratory distress syndrome (ARDS) as the reason for mechanical ventilation (odds ratio ‫؍‬ 0.14, 95% CI 0.04 -0.52, P ‫؍‬ .003) was associated with successful weaning. CONCLUSION: The number of subjects receiving PMV was surprisingly high in this cross-section of Chinese ICUs. In the following 28 ICU days, only a small proportion of these subjects were weaned. Age and chronic heart dysfunction were high risk factors for weaning failure.

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ICU respiratory care equipment and the knowledge to use them are insufficient. Important differences exist in respiratory care practice, which is mostly provided by nurses and physicians. RTs have been gradually recognized and accepted by ICU staff, while professional training and education are needed.

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Interleukin 35 (IL35) has been reported to play a role in acute lung injury (ALI); however, the current results on the relationship between IL35 and ALI are inconsistent. Therefore, we will further determine the function of IL35 in mouse ALI and its potential mechanism in this paper. HE staining and Masson staining were used to evaluate lung injury in mice. Immunohistochemical staining was used to calculate the expression of IL35 p35, TLR4 and MD2 and the ratio of Bax/Bcl2 and p-P65/P65. The expression levels of IL35 EBi3, CD68, CD206 and MPO were detected by immunofluorescence staining. RT–PCR was used to examine the expression levels of IL1β and IL6. TUNEL staining was performed to detect apoptotic cells. Overexpression of IL35 alleviated LPS-induced acute lung injury in mice. IL35 overexpression decreased the expression of CD68 and increased the expression of CD206 in ALI mice. Furthermore, upregulation of IL35 expression obviously reduced the expression of MPO, IL1β and IL6 in lung tissues of mice with ALI. Mechanistically, IL35 suppressed the TLR4/NFκB-P65 pathway, leading to the promotion of M1 to M2 macrophage transition and inflammation relief in ALI in mice.