VENTILATOR RELATED COMPLICATIONS IN INTENSIVE CARE UNITS (ICUS) OF KARACHI

Abstract

INTRODUCTION: Mechanical ventilation (MV) is corner stone of critical caretoday and represents one of the ultimate in life- supporting technologies.Mechanical Ventilation is not a benign therapy and complications are common.OBJECTIVE: The aim of this study was to focus on incidence of ventilatorrelated complications in medical and surgical ICUs in local hospitals.MATERIAL AND METHOD: A prospective, cross-sectional study was conductedat medical (neuro) and surgical ICUs of two hospitals for period of 4months. 50patients (>14 years of age) who required MV for >6 hours were studied. Dataabout each patient admitted to the ICU collected prospectively using a detailedPerforma and entered into computer database.Mean ±SD calculated for numerical variables. Frequency and % calculated forcategorical variables. χ2 test was used for categorical variables. Mann-WhitneyU-test were used to assess differences between duration of intubations andcomplications of ventilator. Differences with P value < 0.05 were consideredstatistically significant.RESULT: The most frequent ICU admission diagnosis in patients with ventilatorassociated complications were neurological disease 24.0%, Road trafficaccident (RTA) 16%, Sepsis 10%, Gun shoot 10%, Laprotomy 8.0%, Pulmonarydisease 6.0%, Poisoning 6.0%, History of fall 4.0%, Hernia 4.0%, Fibroma 2.0%, Myonectomy 2.0%, Cardiac disease 2.0%, Eclampsia 2.0%, hemorrhage 2.0% and hypertention 2.0%. The mean (±SD) days on ventilator prior to development of complications was 15(14.4). More than half of study population consisted of patients of surgical ICU (54%), followed by trauma (24%) and medical ICU (22%). Sixty eight percent (34/50) of patients developed complications, which included complications of intubations 48%, Ventilator operation related complications 14%, and ventilation related complications 34%. The Mann-Whitney U-test suggest that there is statistically significant difference between the duration of intubation and complication of ventilators (z = -2.999, p = 0.003).CONCLUSION: MV complications occurred in 68% (34/50) of patients and mostoften consisted of complication of intubation and ventilator associatedpneumonia. Further studies are needed to examine associated risk factors andstrategies to reduce their occurrence.