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Gulhane Med J. 2005; 47(3): 209-213

Factors affecting mortality in mechanically ventilated patients in the surgical intensive care unit

Mehmet Fatih Can, Gökhan Yağcı, Nihat Kaymakcıoğlu, Semih Görgülü, Ali Harlak, Yusuf Peker, İsmail Arslan, Turgut Tufan.

Mechanical ventilation support is one of the most essential applications in the medical and surgical intensive care units (sICU). Elderly patients admitted to sICU in the preoperative or postoperative periods may require artificial ventilation especially in order to treat acute respiratory failure. In this study, we aimed to determine the prognostic factors affecting the mortality in mechanically ventilated surgical patients. Thirty four patients with a total of 36 mechanical ventilation episodes, who were admitted to sICU during two years period, were included in this study. Demographic data, diagnosis, surgical procedures, simplified acute physiology scores (SAPS II), causes of respiratory failure, duration of mechanical ventilation, tidal volumes, positive end-expiratory pressure levels, adjusted ventilator modes, fractioned oxygen levels, employed weaning methods, success of weaning and patient survival were collected retrospectively. All data were compared between survivors and non-survivors except for weaning methods. Sixteen patients (44.4%) were discharged form sICU and hospital (Survivor group), whereas twenty patients (55.6%) died (Non-survivor group). In this study tidal volumes, SAPS II scores and lowest fractioned oxygen levels were significantly different between survivors and non-survivors. We propose that higher tidal volumes may induce biotrauma and volutrauma by increasing plateau pressures, and also higher SAPS II scores and need for higher levels of fractioned oxygen are indicators of poor prognosis.

Key words: Surgical intensive care unit, mechanical ventilation, mortality

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