Ventilatory habits and outcome of patients admitted in an icu of a tertiary care teaching hospital- a retrospective analysis

Author: 
James Chacko., Asish Karthik., Sruthy Unni and Aparna Satish

Background: Since the advent of mechanical ventilation, there has been tremendous progression and refinement of ventilators, to the extent of Neurally adjusted ventilatory assist (NAVA), High-frequency oscillatory ventilation (HFOV) etc. However to what extent these high-end ventilators are put into use is doubtful. Methodology: We did a retrospective analysis of details of initial ventilatory support provided to patients admitted to Anaesthesia Intensive Care Unit (AICU) of a tertiary care teaching hospital. We also analysed the outcome of these patients. Results: A total of 88% (40%+48%) had good outcome. CMV, SIMV+PS, CPAP, T-Piece were the modes employed with 26.4%, 7.3%,2.5%,0% mortality respectively. Conclusion: we concluded that, whatever modes of ventilation is available with the advanced machines in use, intensivists tent to adhere to the conventional modes of ventilation with proven track record and with which they are familiar with, rather than venturing into the advanced versions especially when dealing with a difficult case. CMV, SIMV+PS,CPAP,T-Piece remains the popular choices and with decreasing order of mortality.

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