Outcomes of prolonged mechanical ventilation.
OBJECTIVE
Patients requiring prolonged mechanical ventilation consume a disproportionate amount of healthcare resources and clinician time. Measurement and knowledge of their outcomes will guide efforts to improve their care.


RESULTS
The number of patients requiring prolonged mechanical ventilation after acute illness is increasing. Their long-term outcome is poor and has not improved significantly over the past 20 years. The symptom burden for patients is considerable, and family members often suffer from significant physical and emotional strain. Long-term survivors report lasting physical limitations, but their emotional health is generally good. Care for many patients requiring prolonged mechanical ventilation is shifting to post-intensive care unit settings. While this trend has resulted in cost savings for hospitals and payers, it has not had a major impact on patient outcomes.


CONCLUSIONS
The long-term outcomes of patients requiring prolonged mechanical ventilation are poor for the majority of patients, especially the elderly. Continued research is needed to identify the highest-risk patients, and to improve outcomes during hospitalization and in the immediate postdischarge period.
Carson
Shannon S
SS
Division of Pulmonary and Critical Care, University of North Carolina, USA. scarson@med.unc.edu
D000368:Aged; D015331:Cohort Studies; D016638:Critical Illness / Q000401:mortality / Q000534:rehabilitation*; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D012121:Respiration, Artificial / Q000009:adverse effects* / Q000401:mortality / Q000523:psychology; D017741:Survivors; D016896:Treatment Outcome