[Development of a quality guarantee system for mechanical ventilation (register in a multi-purpose CCU)].

OBJECTIVE

1. Obtaining information about the demographic distribution of patients undergoing long-term mechanical ventilation. 2. Defining our reference standards for mechanical ventilation, length of UCC and complications related to mechanical ventilation (MV), comparable with the international standards. Detailed follow-up of pneumonias associated to mechanical ventilation and incidence of accidental extubation (AE).

DESIGN

Prospective, descriptive. Period between July 1998 and December 2000. AREA OF STUDY: Multi-purpose critical care unit (12 beds). INDIVIDUALS UNDER STUDY: Patients hospitalized in the critical care unit with any pathology in need of mechanical ventilation.

RESULTS

During the period of study 1058 patients were hospitalized in the critical care unit (CCU), 287 (27%) of which needed mechanical ventilation (MV). 29% of the patients were women. The age and APACHE II were as median (percentile 25 and 75) 68 (57-76) and 26 (20-31) respectively. The reasons that made MV necessary were: acute respiratory failure 70%, intensified acute exacerbation of chronic respiratory failure 11%, coma 18% and neuromuscular illness 1%. The density of average incidence of accidental extubation (AE) was 15.7/1000 days of MV, the AE was associated to a longer duration of MV, longer stay in CCU and in the hospital and a greater incidence of pneumonia associated to MV, but it was not associated to an increment in mortality. The density of incidence of pneumonia associated to MV was 12.6/1000 days of MV, being the germ more frequently responsible the pseudomona aeruginosa.