Critical incidents related to invasive mechanical ventilation in the ICU: preliminary descriptive study.
OBJECTIVE
To establish a preliminary list of critical incidents (CIs) associated with mechanical ventilation and to describe a CI reporting method.


METHODS
A list of CIs was established based on a consensus among ICU caregivers. The list was compared to CIs collected prospectively during a predefined study period.


METHODS
The clinical observations were conducted in two intensive care units.


METHODS
All patients receiving mechanical ventilation were included.


RESULTS
The list of CIs included death and 62 other CI types categorized as immediately life-threatening, secondarily life-threatening, or non-life-threatening. The observational study identified 527 CIs in 137 patients. Virtually all non-life-threatening CIs were ascribed to failure to comply with safety rules or to equipment failure and 40% of life-threatening CIs to the course of the disease or to patient-related factors. The match between CI types on the list and CI types observed in the ICUs was excellent.


CONCLUSIONS
Use of our reporting method to create a CI database in a multicenter study including ICUs with varying recruitment patterns may help to identify markers suitable for routine continuous use as part of a quality-assurance program.
Auriant
I
I
Surgical Respiratory Intensive care Unit, Marie lannelongue Surgical Center, le Plessis Robinson, France. auriant@ccml.com
Reignier
J
J
Pibarot
M L
ML
Bachat
S
S
Tenaillon
A
A
Raphael
J C
JC
D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D008875:Middle Aged; D016730:Program Development; D011785:Quality Assurance, Health Care / Q000379:methods*; D012121:Respiration, Artificial / Q000009:adverse effects*; D012308:Risk Management / Q000379:methods*