SURVIVAL FOLLOWING MECHANICAL VENTILATION FOR ACUTE RESPIRATORY-FAILURE IN ADULT MEN

Study design: Survival following mechanical ventilation for acute resp iratory failure has important implications for medical decision-making and allocation of expensive resources for critical care. Procedure: W e reviewed a 5-year experience with mechanical ventilation in 383 men with acute respiratory failure and studied the impact of patient age, cause of acute respiratory failure, and duration of mechanical ventila tion on survival. Survival rates were 66.6 percent to weaning, 61.1 pe rcent to ICU discharge, 49.6 percent to hospital discharge, and :30.1 percent to 1 year after hospital discharge. When our data were combine d with 10 previously reported series, mean survival rates were calcula ted to be 62 percent to ventilator weaning, 46 percent to ICU discharg e, 43 percent to hospital discharge, and 30 percent to 1 year after di scharge. Of 255 patients weaned from mechanical ventilation, 44 (17.3 percent) required an additional period of mechanical ventilation durin g the same hospitalization. Results: Age had a significant influence o n survival to hospital discharge and on that to 1 year after hospital discharge, and the cause of acute respiratory failure had a significan t influence on survival only to weaning. Survival was best in younger patients and those with COPD or postoperative respiratory failure and worst in patients resuscitated after cardiac or respiratory arrest. In creased duration of mechanical ventilation significantly reduced survi val only to hospital discharge. Overall survival was significantly aff ected by age ana cause of acute respiratory failure, but not by durati on of mechanical ventilation. Conclusion: We conclude that age, cause of acute respiratory failure, and duration of mechanical ventilation h ave specific influences on the generally poor outcome of mechanical ve ntilation for acute respiratory failure.