[Mechanical ventilation in patients with acute neurological disease: survival and functional outcome].
BACKGROUND
The need of mechanical ventilation among patients with acute neurological diseases is considered a poor prognostic sign.


OBJECTIVE
To determine the mortality and functional recovery of neurological patients requiring mechanical ventilation.


METHODS
Prospective study of 77 patients (42 men, age 54+/-19 years, with 11+/-4 points of Glasgow coma scale (GCS), 61% with cerebrovascular disease), that were admitted to the intensive care unit with neurological disease and that required mechanical ventilation. Functional recovery was assessed at 18 months with Glasgow outcome scale (GOS) and Barthel index.


RESULTS
Thirty percent of patients died during follow up. Among surviving patients, 47% had a good recovery or moderate disability, and 74% had a Barthel index equal to or over 70. Arterial hypertension, age over 70 and mechanical ventilation longer than 6 days were associated with bad functional prognosis.


CONCLUSIONS
Neurological patients requiring mechanical ventilation had a lower mortality than previously reported, and half of the survivors have an independent life. This study supports intensive care management in this group of patients.
Norero
Enrique
E
Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Altschwager
Pablo
P
Romero
Carlos
C
Mellado
Patricio
P
Hernández
Glenn
G
Castillo
Luis
L
Bugedo
Guillermo
G
D000208:Acute Disease; D002493:Central Nervous System Diseases / Q000401:mortality* / Q000628:therapy; D003422:Critical Care; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012121:Respiration, Artificial; D017741:Survivors
Ventilación mecánica en pacientes con patologías agudas del sistema nervioso central: sobrevida y pronóstico funcional.