Mechanical Ventilation in the Intensive Care Unit: A Prospective Study of Indications and Factors that Affect Outcome in a Tertiary Hospital in Nigeria

Abstract

The need for ventilatory support is one of the commonest indications for admission into the intensive care unit (ICU). Despite the usefulness of mechanical ventilation, its damaging effect on the lungs has also been widely recognized.The study was a prospective, case-controlled survey of all mechanically ventilated patients admitted in our ICU from November 2013 to April 2014. For every ventilated patient, a non-ventilated similar patient served as a control.A total of 128 patients were admitted into the ICU over the six month period and 44 patients constituting 34.4% were mechanically ventilated. The average duration of mechanical ventilation was 12.30 ± 10.10 days. Duration of mechanical ventilation, use of arterial blood gas measurement and ionotropic support had significant effect on weaning from ventilation with p values of 0.005, 0.05 and <0.001 respectively. Mechanically ventilated patients had >4 times chance of death than non-ventilated patients.Mechanical ventilation though a useful therapeutic intervention in the ICU is associated with increased mortality. Duration of ventilation, use of arterial blood gas (ABG) and need for ionotropic support influenced successful weaning off ventilator. It may be expedient therefore to weigh the risk: benefit assessment of mechanical ventilation before commencement in the ICU.

Outcomes of Patients on Mechanical Ventilation among Adult Intensive Care Units of Tikur Anbesa Specialized Hospital, Addis Ababa , Ethiopia

“…This low ventilatory rate in our ICU could be due to inadequate availability of ventilators, setup difference, the number of ICU and number of patients. In contrast our result is higher than from studies conducted in Mekelle, Egypt, Nigeria and Mumbai reported by 36.7%, 40%, 34.4%, and 34.5% respectively (7,9,12,18,19). This difference may be due to our study was conducted in tertiary hospital which served for variety of patients referred from different region of the country.…”

Characteristics and Outcomes of Mechanically Ventilated Patients at Adult ICU of Selected Public Hospitals in Addis Ababa, Ethiopia

“…The report from different published study shows 34% in Brazil, 42.1% in central India, 67.21% in western India, 31.8% in Nigeria, 64% in Egypt, 73.5% in Uganda and 28.6% in Ayder Hospital, Ethiopia. 5,6,11,15,16,18,19 Our findings were almost the same as the study conducted by Chiwhane and Diwan, which reported 42.1%. On other hand, our finding was higher than the studies conducted in Brazil (34%), Nigeria (31.8%), and Ayder Hospital, Ethiopia (28.6%).…”

“…This finding was in line with other published studies in India, Chile, Nigeria, and Ethiopia, which ranged from 38.6% to 86.07%. 5 , 9 , 11 , 16 Nevertheless, the study conducted in Cairo prevails cardiac disease as the predominant indication of mechanical ventilation. This discrepancy in indication might be due to the type of intensive care unit and the difference in the category of diseases in the setting.…”

Knowledge Regarding Mechanical Ventilation and Practice of Ventilatory Care among Nurses Working in Intensive Care Units in Selected Governmental Hospitals in Addis Ababa, Ethiopia: A Descriptive Cross-Sectional Study

“…Te continuous development of mechanical ventilators and their clinical use have been critical factors for the development and growth of critical care and respiratory professions [1,2].…”

“…Mechanical ventilator support is one of the main indications for admission to the intensive care unit (ICU). The continuous development of mechanical ventilators and their clinical use have been critical factors for the development and growth of critical care and respiratory professions [ 1 , 2 ].…”