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Báo cáo y học: " Mechanical ventilation in rural ICUs"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Mechanical ventilation in rural ICUs. | Research paper 23 Mechanical ventilation in rural ICUs John F Fieselmann M Jeanne Bock Michael S Hendryx Douglas Wakefield Charles M Helms and Suzanne E Bentler Background In recent years rural hospitals have expanded their scope of specialized services which has led to the development and staffing of rural intensive care units ICUs . There is little information about the breadth quality or outcomes of these services. This is particularly true for specialized ICU services such as mechanical ventilation where little if any information exists specifically for rural hospitals. The long-term objectives of this project were to evaluate the quality of medical care provided to mechanically ventilated patients in rural ICUs and to improve patient care through an educational intervention. This paper reports baseline data on patient and hospital characteristics for both rural and rural referral hospitals. Results Twenty Iowa hospitals were evaluated. Data collected on 224 patients demonstrated a mean age of 70 years and a mean ICU admission Acute Physiology and Chronic Health Evaluation APACHE II score of 22 with an associated 36 mortality. Mean length of ICU stay was 10 days with 7.7 ventilated days. Significant differences were found in both institutional and patient variables between rural referral hospitals and rural hospitals with more limited resources. A subgroup of patients with diagnoses associated with complex ventilation had higher mortality rates than patients without these conditions. Patients who developed nosocomial events had longer mean ventilator and ICU days than patients without nosocomial events. This study also found ICU practices that frequently fell outside the guidelines recommended by a task force describing minimum standards of care for critically ill patients with acute respiratory failure on mechanical ventilation. Conclusions Despite distinct differences in the available resources between rural referral and rural hospitals overall mortality .