Chronic ventilator dependence in elderly patients

Long-term ventilator dependence is the need for mechanical ventilation for more than 6 h/d for more than 21 days. Long-term ventilator dependence comp licates 9% to 20% of the episodes of mechanical ventilation treated in the intensive care units of acute care hospitals; it is associated with an aver age mortality rate of 40%. Unlike acute respiratory failure, the risk for w hich does not increase with age, long-term ventilator dependence falls disp roportionately to patients aged 70 years or older. During the past 2 decade s, a profusion of care sites for patients with long-term ventilator depende nce has evolved, largely as the product of the prospective payment system f or health services introduced by the Health Care Financing Administration i n 1983. The outcome of long-term ventilator dependence in elderly patients across this health care continuum is addressed.