Based on this large cohort of intubated patients, mortality was 10% for the patients entering the weaning process but was three times higher (33%) in patients failing their 1st WA; 63% of the deaths occurred within one week after the failed WA.
Two-thirds of intubated patients will be intubated for a median of 45 hours post admission.
The few published studies suggest that significant mortality or morbidity associated with interfacility transport of intubated adult patients is uncommon; however, there are significant limitations to the available data.
Ventilator associated pneumonia (VAP) is the most common infection found in intensive care units (ICU's), with a prevalence of 47% of total infections in ICU[ 14]; 25% of all nosocomial infections, with an estimated 5 to 10 VAP cases per 1000 hospital admissions and 9 – 27% of intubated patients with an attributable mortality of 33% [ 15, 16].
Although IMV within 24 hours of ICU admission was not associated with hospital mortality after adjustment for other prognostic factors, 70.2% of intubated patients died compared with 45.3% of nonintubated patients.
Insufficient data exist to draw firm conclusions regarding the mortality, morbidity, or risk factors associated with the interfacility transport of intubated and mechanically ventilated adult patients.
Thus, our mortality rate of 48% in ARDS patients who failed NIV and required intubation is in line with these cohort studies of intubated patients.
Optimally, the results should be validated in another cohort of intubated ICU patients with complete follow-up on mechanical ventilation and mortality for 28 days, and where these two biomarkers were analyzed.
He has battled through 35 days of intubated ventilation, a further 30 days on CPAP ventilation, Meningitis, four blood transfusions, a hydrocele and hernia operation.
