Non-ICU care of hemodynamically stable mechanically ventilated patients - PubMed (original) (raw)
Non-ICU care of hemodynamically stable mechanically ventilated patients
B Latriano et al. Chest. 1996 Jun.
Abstract
Objective: To analyze a 4 1/2-year experience caring for hemodynamically stable mechanically ventilated patients on a nonmonitored respiratory care floor (RCF) for therapeutic outcome, utilization, and costs.
Design: A retrospective medical records review.
Setting: ICUs and an RCF of a university-affiliated tertiary care center.
Participants: Two hundred twenty-four patients requiring more than 24 h of mechanical ventilation cared for on the RCF.
Results: The mean age of patients was 67 +/- 17 years. Of the admissions, 58% were from the medical ICU, 28% were from surgical ICUs, and 9.4% were from general medical floors. Patients spent 50 +/- 66 days mechanically ventilated on the RCF. Overall survival was 50.4% with 93.8% of surviving patients successfully weaned from mechanical ventilation. Survival by diagnostic group demonstrated highest probability of survival in patients with trauma and lowest in patients with multisystem failure. Of the survivors, 39% were discharged home, 34% to a rehabilitation unit, and 24% to a skilled nursing facility. Savings based on differential of costs between the ICU and RCF, primarily from reduced staffing requirements, were estimated at $4.1 million.
Conclusion: Use of a nonmonitored RCF for the care of hemodynamically stable mechanically ventilated patients yields acceptable therapeutic outcomes while providing the institution with increased flexibility in critical care bed management and significant financial savings.
Similar articles
- Implementation of an institutional program to improve clinical and financial outcomes of mechanically ventilated patients: one-year outcomes and lessons learned.
Burns SM, Earven S, Fisher C, Lewis R, Merrell P, Schubart JR, Truwit JD, Bleck TP; University of Virginia Long Term Mechanical Ventilation Team. Burns SM, et al. Crit Care Med. 2003 Dec;31(12):2752-63. doi: 10.1097/01.CCM.0000094217.07170.75. Crit Care Med. 2003. PMID: 14668611 - Mechanical ventilation of patients hospitalized in medical wards vs the intensive care unit--an observational, comparative study.
Hersch M, Sonnenblick M, Karlic A, Einav S, Sprung CL, Izbicki G. Hersch M, et al. J Crit Care. 2007 Mar;22(1):13-7. doi: 10.1016/j.jcrc.2006.06.004. Epub 2007 Jan 31. J Crit Care. 2007. PMID: 17371738 - Clostridium difficile infection: a multicenter study of epidemiology and outcomes in mechanically ventilated patients.
Micek ST, Schramm G, Morrow L, Frazee E, Personett H, Doherty JA, Hampton N, Hoban A, Lieu A, McKenzie M, Dubberke ER, Kollef MH. Micek ST, et al. Crit Care Med. 2013 Aug;41(8):1968-75. doi: 10.1097/CCM.0b013e31828a40d5. Crit Care Med. 2013. PMID: 23863229 - Early Rehabilitation in the Medical and Surgical Intensive Care Units for Patients With and Without Mechanical Ventilation: An Interprofessional Performance Improvement Project.
Corcoran JR, Herbsman JM, Bushnik T, Van Lew S, Stolfi A, Parkin K, McKenzie A, Hall GW, Joseph W, Whiteson J, Flanagan SR. Corcoran JR, et al. PM R. 2017 Feb;9(2):113-119. doi: 10.1016/j.pmrj.2016.06.015. Epub 2016 Jun 23. PM R. 2017. PMID: 27346093 - Association of opioid exposure during intensive care unit stays with post-discharge opioid use: A retrospective study and literature review.
Mo Y, Zeibeq J, Mesiha N, Bakar A, Sarsour M, Liu M, Gasperino J. Mo Y, et al. J Opioid Manag. 2021 Nov-Dec;17(6):511-516. doi: 10.5055/jom.2021.0685. J Opioid Manag. 2021. PMID: 34904699 Review.
Cited by
- Reinstitution of mechanical ventilation within 14 days as a poor predictor in prolonged mechanical ventilation patients following successful weaning.
Tu ML, Tseng CW, Tsai YC, Wang CC, Tseng CC, Lin MC, Fang WF, Chen YC, Liu SF. Tu ML, et al. ScientificWorldJournal. 2012;2012:957126. doi: 10.1100/2012/957126. Epub 2012 Jul 31. ScientificWorldJournal. 2012. PMID: 22924030 Free PMC article. - Prospective observational cohort study of patients with weaning failure admitted to a specialist weaning, rehabilitation and home mechanical ventilation centre.
Mifsud Bonnici D, Sanctuary T, Warren A, Murphy PB, Steier J, Marino P, Pattani H, Creagh-Brown BC, Hart N. Mifsud Bonnici D, et al. BMJ Open. 2016 Mar 8;6(3):e010025. doi: 10.1136/bmjopen-2015-010025. BMJ Open. 2016. PMID: 26956162 Free PMC article. - Respiratory intensive care units in Italy: a national census and prospective cohort study.
Confalonieri M, Gorini M, Ambrosino N, Mollica C, Corrado A; Scientific Group on Respiratory Intensive Care of the Italian Association of Hospital Pneumonologists. Confalonieri M, et al. Thorax. 2001 May;56(5):373-8. doi: 10.1136/thorax.56.5.373. Thorax. 2001. PMID: 11312406 Free PMC article. - Mechanical ventilation patterns and trends over 20 years in an Israeli hospital system: policy ramifications.
Zisk-Rony RY, Weissman C, Weiss YG. Zisk-Rony RY, et al. Isr J Health Policy Res. 2019 Feb 1;8(1):20. doi: 10.1186/s13584-019-0291-y. Isr J Health Policy Res. 2019. PMID: 30709421 Free PMC article. - Outcomes of prolonged mechanic ventilation: a discrimination model based on longitudinal health insurance and death certificate data.
Lu HM, Chen L, Wang JD, Hung MC, Lin MS, Yan YH, Chen CR, Fan PS, Huang LC, Kuo KN. Lu HM, et al. BMC Health Serv Res. 2012 Apr 25;12:100. doi: 10.1186/1472-6963-12-100. BMC Health Serv Res. 2012. PMID: 22531140 Free PMC article.
MeSH terms
LinkOut - more resources
Full Text Sources