title: Mechanical ventilation in the emergency department for 24 hours or longer is associated with delayed weaning.
abstract: OBJECTIVE
  We examined various aspects of critical care to identify factors in the emergency department (ED) that affected the overall duration of mechanical ventilation (MV). We specifically focused on whether 24 hours of ED MV affected the weaning success and the duration of MV.
  
  
  METHODS
  Mechanical ventilation cases that started in the ED because of purely respiratory problems were enrolled in the retrospective cohort. We recorded demographic data, duration of MV in ED, various severity scores, previously known factors of prolonged MV, and achievement of ventilator weaning. All the significant factors in univariate survival analyses were included in a multivariate analysis.
  
  
  RESULTS
  The estimated median of the entire duration of MV was longer in patients who received 24 hours or more of MV in ED compared with that of patients who received MV for less than 24 hours (33.0 vs 15.4 days, P = .003). Mechanical ventilation for longer than 24 hours in the ED remained a significant factor that prolonged the entire MV duration in the multivariate analysis (hazard ratio, 0.577; P = .019). Hypoalbuminemia and abbreviated mortality in ED sepsis (MEDS) score were also independently correlated (P ≤ .001 for both).
  
  
  CONCLUSIONS
  Mechanical ventilation in the ED for 24 hours or longer is associated with delayed ventilator weaning.
authors.affiliation: Department of Emergency Medicine, Yonsei University College of Medicine, 250 Sungsan-Ro, Seodaemun-Gu, Seoul, Republic of Korea. hendrix74@gmail.com
authors.forename: Tae Nyoung
authors.initials: TN
authors.lastname: Chung
authors.forename: Inki
authors.initials: I
authors.lastname: Yoon
authors.forename: Je Sung
authors.initials: JS
authors.lastname: You
authors.forename: June Young
authors.initials: JY
authors.lastname: Lee
authors.forename: Incheol
authors.initials: I
authors.lastname: Park
authors.forename: Sung Phil
authors.initials: SP
authors.lastname: Chung
authors.forename: Seung Ho
authors.initials: SH
authors.lastname: Kim
mesh_terms: D000368:Aged; D015897:Comorbidity; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013997:Time Factors; D015300:Ventilator Weaning / Q000706:statistics & numerical data*