The Clinic Application Analysis Of The Mechanical Ventilation In ICU

Objective: To summarize the data of invasive mechanical ventilation (MV) clinic application in the central intensive care unite(ICU),including the construction of the main primary disease, the clinic application feature in the different disease, the common complication and the weaning of MV. Elevate the technique of the MV clinic application.Methods: Admitted the patients'data who was erected artificial airway and applied multifunction mico-computer ventilation from Jan 1st 2006 to Dec 31st 2006 in the central ICU of the first affiliated hospital of Chongqing university of medical sciences . According to the data from the medical record library, including the protopathy, the length of stay, the time of use the MV, the complication and turnover etc. Make them statistical analyze. The patients all were given APACHEâ…¡score and the coefficient of death risk.Result: There were 426 patient in the central ICU in 2006, and 194 were applied the invasive MV. It was 45.54%. The protopathies were 24. The 5 disease in head were: cerebral accident 26(13.4%), after operation 24(12.4%), acute episode of chronic obstructive pulmonary(AECOPD) 23(11.9%), multiple injury 22(11.3%), servers acute abdomen 14(7.2%). Success in the weaning of MV were 74(38.1%), quit to death 34(17.5%), unsuccess in the weaning of MV 63(32.5%), The death rate is 50% , auto-discharge 23(11.9%). Among them ,the most high of success withdrew MV rate were: after operation(83.3%), servers acute abdomen(71.4%), the most high death rate were: sepsis(90.9%), cachexia(87.5%), cerebral accident(84.6%).In the invasive MV course, the most common complication included: ventilator associated pneumonia(VAP) 86(44.3%), death rate was 44.2%, in which there were 23(26.74%) showed infection of mycetes by sputum culture; mucosa injury 75(38.7%), pulmonary closure 34(17.5%), death rate was 58.8%. The different disease had the different incidence rate of the complication. The most high of VAP is the AECOPD(60.9%), of the pulmonary closure is the multiple injury(45.4%).When the protopathy was controlled, the ventilation and gas exchange of patients became better, weaning of MV was need for recovery spontaneously breathing. The shortest of the MV application time was the after operation , the longest was the multiple injury. Between the success and the unsuccess, the APACHEâ…¡score , the coefficient of death risk, the age and the time of the MV application exist difference obviously.Conclusion: The protopathy in the central ICU was multiple. The patient who were applied MV were servers. It is high death rate(50%). Different protopathy had the different use of the MV. We could according to the APACHEâ…¡score and the coefficient of death risk estimate the prognosis of the patient.VAP, mucosa injury and pulmonary closure were the common complication. The drug treatment, the normalization of medical treat operation could reduce the happen of them.It is importent for the weaning of MV, which was the protopathy and how long used MV. Treat the protopaty , stabilize the internal environment, create the condition actively, grasp the opportunity accurately, design a program stably, all of them were critically.