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VOLUME 61 , ISSUE 1 ( January-March, 2019 ) > List of Articles

Original Article

Aetiology and Predictors of Outcome in Patients Presenting with Acute Respiratory Failure Requiring Mechanical Ventilation in a Medical Intensive Care Unit

J. Harikrishna, Alladi Mohan, P. Sumanth Reddy, Prerna S. Sharma, P.V. Aditya Kumar, K.K. Guntupalli, K.V.S. Sarma, M.H. Rao

Keywords : Acute respiratory failure, Aetiology, Outcome, Mechanical ventilation

Citation Information : Harikrishna J, Mohan A, Reddy PS, Sharma PS, Kumar PA, Guntupalli K, Sarma K, Rao M. Aetiology and Predictors of Outcome in Patients Presenting with Acute Respiratory Failure Requiring Mechanical Ventilation in a Medical Intensive Care Unit. Indian J Chest Dis Allied Sci 2019; 61 (1):7-11.

DOI: 10.5005/ijcdas-61-1-7

License: CC BY-NC 4.0

Published Online: 18-11-2022

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

Background: Sparse published data are available regarding the aetiology, course, complications and outcome in patients presenting with acute respiratory failure requiring mechanical ventilation from India. Methods: Retrospective study of 116 patients with acute respiratory failure requiring mechanical ventilatory support (AcRFMV) in the medical intensive care unit (ICU) at our tertiary care teaching hospital in South India. Results: Patients with AcRF-MV (mean age 44.5±19.5 years; 52.6% females) constituted 23.9% of the 486 patients admitted to the medical ICU during the study period of 18 months. Aetiological causes included sepsis syndrome (46.6%), acute deliberate selfpoisoning (22.4%), acute exacerbation of chronic obstructive pulmonary disease (15.5%), snake bite and tuberculosis (5.2% each), severe complicated malaria (3.4%), among others. The median (interquartile range [IQR]) duration (days) of mean hospital stay and medical ICU stay were 10 (4-13.8) and 7 (4-11), respectively. Median (IQR) duration of mechanical ventilator support was 5 (3-8) days. Complications observed during medical ICU stay were ventilator-associated pneumonia (13.8%), bed sore (7.8%), pneumothorax (2.6%); 12.1% patients required tracheostomy. Fifty-eight (50%) patients died. On multivariable analysis using binary logistic regression (forward conditional method) shock at initial presentation (odds ratio [OR] = 3, 95% confidence intervals [CI] 1.638-5.493, p<0.001) emerged as independent predictor of death. Conclusions: Acute respiratory failure requiring mechanical ventilatory support is an important cause of admission to medical ICU and is associated with high mortality. Intense search for and monitoring of predictor variables can help clinicians in reducing the mortality.

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