EARLY PREDICTION OF PROLONGED VENTILATOR DEPENDENCE IN THERMALLY INJURED PATIENTS

Background: Recent studies suggest that when prolonged ventilator depe ndence (PVD) can be predicted in trauma or intensive care unit patient s, early tracheostomy may reduce hospital stay and improve utilization of resources. This study was performed to develop criteria predictive of PVD (>14 days) in burn patients, Methods: We reviewed burn patient s aged greater than or equal to 16 years admitted between 1990 and 199 4 who required ventilator support for greater than or equal to 3 days, Using the variables full-thickness burn size, age, inhalation injury, and worst Pao(2)/Fio(2) on ventilator day 3, an equation predicting P VD was created using logistic regression. The equation was tested by a pplying it to 1995 patients, Results: When a probability of >0.5 was c onsidered predictive of PVD, the equation correctly predicted PVD in 8 2% of 1990 to 1994 patients (n = 110) and 90% of 1995 patients (n = 29 ), Conclusion: PVD in burn patients can be predicted using objective v ariables in the early postburn period, Predictions can be used to sele ct patients for prospective studies of early tracheostomy.