Fatores prognósticos relacionados à ventilação mecânica prolongada

Abstract

The ventilatory support provided by mechanical ventilation (MV) is a method used to maintain pulmonary functionality in patients with respiratory failure. Despite the fact that most patients remain on MV for short periods of time, there is a considerable rate of need for prolonged MV (VMP), defined as a period greater than or equal to 21 days. The aim of this study was to analyze factors related to prolonged mechanical ventilation (PMV), such as sociodemographic indicators, diagnosis, comorbidities, severity of the condition, time on MV and complications. A total of 341 patients with a median (p25-p75) aged 66 (53-74) years were evaluated, with a predominance of men (58.9%), median (p25-p75) of 7-day ICU time (3.0 - 6.0) and 4-day MV (2.0 - 12.0). The APACHE II score was 24 (20.0 - 29.0). The most prevalent diagnosis was of diseases of the circulatory system (ICD I) 140 (41.1). There were 143 (41.9%) deaths, 45 (13.2%) patients remained on MV for more than 21 days, 12 (3.5%) required reintubation and 79 (23.0%) underwent TQT and the incidence of PAV was 7%. When analyzing factors related to PMV, an association was observed in patients with sedation> 3 days in the first 5 days, those who evolved to cardiorespiratory arrest, with pneumonia associated with MV, reintubated, with longer time for tracheostomy, longer hospital stay and mortality. It is concluded, in this study, that the PMV has a greater relationship with the clinical evolution of the patients than the scores used in the first 24 hours of hospitalization.