Clinical characteristics and determinants of invasive mechanical ventilation outcome in adult intensive care unit in Northern Ethiopia: A resource-limited setting

Abstract

Objectives: Mechanical ventilation (MV) is a primary modality of supporting organ function in patients who are treated in intensive care units (ICUs). Although it is lifesaving, it is also associated with life-threatening complications. This study aims to address the existing paucity of evidence on clinical characteristics and determinants of invasive MV outcomes in adult ICU in North Ethiopia. Materials and Methods: The study was conducted in the adult ICU of Ayder Comprehensive Specialized Hospital. A hospital-based prospective study was conducted to collect data using the purposive sampling technique to include all the patients who received invasive MV from January 2017 to October 2017. Data were analyzed using SPSS version 23. Results: MV was utilized in 36.7% (n = 105) of critically ill patients admitted to the ICU. The two most common indications for invasive MV use were hypoxic respiratory failure 44.8% (n = 47) and coma 35.2% (n = 37). The mortality rate among patients who received invasive MV was 28.6%. Age above 60 years and development of septic shock after intubation were significant determinants of invasive MV-related mortality. Conclusion: A significant number of patients admitted to the ICU require respiratory support with invasive MV. Old age and the development of septic shock after intubation were significant determinants of mortality for patients under invasive MV.

Clinical presentation, maternal-fetal, and neonatal outcomes of early-onset versus late onset preeclampsia-eclampsia syndrome in a teaching hospital in a low-resource setting: A retrospective cohort study

“…The higher prevalence of maternal mortality associated with PE-E syndrome in low resource settings could be related to late presentation of patients associated with lack of proper knowledge, limited access to quality antenatal care [ 33 , 34 ], and poor obstetric care provision in health institutions due to resource constraints in such settings [ 35 ]. Moreover, in the study setting availability of intensive care is limited [ 26 ] and the only available intensive care unit is reported to have a high level of mortality [ 36 ]. Moreover, The shortage of blood and the blood products and lack of appropriate antibiotics to treat simultaneously occurring and/or complicating PE-E syndrome are prevalent in the study setting.…”

“…care unit is reported to have a high level of mortality [36]. Moreover, The shortage of blood and the blood products and lack of appropriate antibiotics to treat simultaneously occurring and/or complicating PE-E syndrome are prevalent in the study setting.…”

Prevalence of mortality and associated factors among ICU admitted adult patients with mechanical ventilation in Ethiopia; Systematic review and meta-analysis

“…Admission with a cardiovascular diseases were consistently emerged as a significant factor associated with mortality in four prior studies, with adjusted ORs (AORs) ranging from 1.04 to 5.05 (12,22–24). Another critical determinant of mortality is the presence of sepsis or septic shock, as evidenced by AORs ranging from 1.938 to 7.4 in previous studies (11,24). Furthermore, a GCS level of ≤8 was identified as a predictor of mortality in two studies, with ORs ranging from 0.85 to 6.3 (12,22–25).…”

“…Studies have consistently shown that ICU patients requiring MV have higher mortality rates compared to those not requiring respiratory support, emphasizing the critical condition of these patients. Historically, Ethiopia has reported a high ICU mortality rate for patients requiring MV (10), with mortality rates among patients on MV ranging from 28.6% to 62.1% (11,12). However, the possibility of MV-related complications and other contributing factors escalating the mortality rate cannot be discounted.…”