Capítulo de Kinesiología Intensivista, Sociedad Argentina de Terapia Intensiva, CABA, Argentina; Hospital Británico de Buenos Aires, CABA, Argentina; Docente Adjunto de Cátedra de Kinesfisiatría Cardiorrespiratoria de la Carrera de Kinesiología y Fisiatría, Universidad Abierta Interamericana, CABA, Argentina; Director del Grupo de Estudios Especializados en VM, Universidad Abierta Interamericana, CABA, Argentina.
Capítulo de Kinesiología Intensivista, Sociedad Argentina de Terapia Intensiva, CABA, Argentina.
Med Intensiva (Engl Ed). 2022 Jul;46(7):372-382. doi: 10.1016/j.medine.2022.05.002. Epub 2022 May 31.
To describe mechanical ventilation (MV) practices in Argentina, and to explore factors associated with ICU mortality in this population.
A prospective, multicenter, observational study was carried out.
Intensive Care.
We enrolled patients above 18 years old admitted to any of the participating ICUs requiring invasive MV for at least 12 h since the admission to the healthcare institution, including MV initiation in emergency department, operating room or other hospitals.
None.
All variables were classified into three categories: variables related to demographic and clinical factors before the MV, factors related to the first day on MV, and factors related to events happening during the MV (complications and weaning from MV). Mechanical ventilation weaning and mortality were classified according to WIND.
The primary analysis included 950 patients. The main indication for MV was acute respiratory failure (58% of patients). Initial ventilation mode was volume control-continuous mandatory ventilation in 75% of cases. ICU and hospital mortality were 44.6% and 47.9% respectively. The variables identified as independent predictors of mortality in ICU were age (OR 3.48 IC 95% 1.22-11.66; p = 0.028), failure to implement NIV before MV (OR 2.76 IC 95% 1.02-7.10; p = 0.038), diagnosis of sepsis (OR 2.46 IC 95% 1.09-5.47; p = 0.027) and extubation failure (OR 4.50 IC 95% 2.05-9.90; p < 0.001).
The present study allowed us to describe the characteristics and clinical course of the patients who received mechanical ventilation in Argentina, finding as the main result that mortality was higher than that reported in international studies.
描述阿根廷的机械通气（MV）实践，并探讨与该人群 ICU 死亡率相关的因素。
一项前瞻性、多中心、观察性研究。
重症监护病房。
我们招募了年龄在 18 岁以上的患者，这些患者因急性呼吸衰竭需要接受至少 12 小时的有创 MV，包括在急诊室、手术室或其他医院开始 MV。
无。
所有变量分为三类：MV 前与人口统计学和临床因素相关的变量、与 MV 第 1 天相关的变量，以及与 MV 期间发生的事件（并发症和 MV 撤机）相关的变量。MV 撤机和死亡率根据 WIND 进行分类。
主要分析纳入了 950 名患者。MV 的主要指征是急性呼吸衰竭（58%的患者）。初始通气模式为容量控制-持续强制通气，占 75%的病例。ICU 和医院死亡率分别为 44.6%和 47.9%。ICU 死亡率的独立预测因素包括年龄（OR 3.48，95%CI 1.22-11.66；p = 0.028）、MV 前未实施无创通气（OR 2.76，95%CI 1.02-7.10；p = 0.038）、败血症诊断（OR 2.46，95%CI 1.09-5.47；p = 0.027）和拔管失败（OR 4.50，95%CI 2.05-9.90；p < 0.001）。
本研究描述了在阿根廷接受机械通气治疗的患者的特征和临床过程，主要结果是死亡率高于国际研究报告的死亡率。
