Outcome of patients cared for in a ventilator-dependent unit in a general hospital

D. R. Gracey, J. M. Naessens, R. W. Viggiano, G. E. Koenig, M. D. Silverstein, R. D. Hubmayr

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Abstract

We describe our initial experience with the admission of 129 patients for 132 episodes of ventilator-dependence to a self-contained ventilator- dependent unit (VDU) in a general hospital and present a survival comparison between VDU patients and a historic control population from the same institution. Forty-three patients were screened and denied admission to the VDU because long-term ventilator dependence was not felt to be a probable outcome (56%); they were medically unstable, often requiring electrocardiographic monitoring (19%), they had poor rehabilitation potential because of markedly depressed mental status (13%), or they preferred to be treated closer to their homes (12%). Thirteen (9.8%) of the VDU patients died in the hospital compared to 44 (42%) in the historic control group. After exclusion of patients with multiorgan failure (who made up 26% of the control group) and using a proportional hazard model to adjust for group differences in age and disease class, the difference in hospital mortality remained highly significant (p≤0.01). Ninety-one of the 119 VDU patients (77%) were ultimately able to return home; 16 (13%) continued to use a ventilator intermittently at night; 26 patients (22%) were permanently placed in nursing homes, all off of the ventilator. Overall, 88% of the 119 patients discharged had been liberated from mechanical ventilation. Ninety-seven (82%) and 86 (72%) remain alive 1 and 2 years after discharge, respectively. Some of the survival benefits may be directly attributed to the VDU. Others reflect a change in treatment philosophy, which was nevertheless reinforced by our VDU experience.

Original languageEnglish (US)
Pages (from-to)494-499
Number of pages6
JournalChest
Volume107
Issue number2
DOIs
StatePublished - Jan 1 1995

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Keywords

  • prolonged mechanical ventilator
  • ventilator dependence
  • ventilator weaning

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Gracey, D. R., Naessens, J. M., Viggiano, R. W., Koenig, G. E., Silverstein, M. D., & Hubmayr, R. D. (1995). Outcome of patients cared for in a ventilator-dependent unit in a general hospital. Chest, 107(2), 494-499. https://doi.org/10.1378/chest.107.2.494