Utilization of mechanical ventilators in low resource Faculty: a cross sectional study

Abstract

Background Few studies are available from Africa on the use of mechanical ventilation (MV) in the pediatric intensive care unit (PICU). Knowledge of the outcome of patients on MV is critical for better use of resources and clinical decision making. We aimed to see the outcome and pattern of patients treated in a pediatric intensive care unit in a teresery hospital, which is the first study to evaluate an Ethiopian PICU. Methods A cross-sectional study with retrospective data collection was employed. Data were abstracted from the patients’ medical records by trained health professionals. SPSS version 21 software was used for data entry and analysis. The reports were depicted descriptively using measures of central tendency, dispersion, and displayed through tables and graphs. Results There were 536 patients admitted during the study period. 202 (41.2%) incidence of mechanical ventilation (MV) rate 63.6% of the participants were males and 130 (59.1%) died. The most common indication for the initiation of MV was respiratory problems 46 (20.9%). we identified 30.59/1000 ventilator days developed complications.Ventilator-associated pneumonia accounted for 18.6% of the complications with 20.9/1000 ventilator days. Survival of medical cases was better than the surgical cases (including trauma); [AOR = 0.13, 95% CI(0.04–0.413)] and those who have MV for more than 3 days are 79% more likely to die than those of less than 3 days ventilated; (p = 0.003). Those who have multi-organ dysfunction syndrome die more likely than the other group of patients; [AOR = 0.181, 95% CI (0.08, 0.412)] and the patient who had high PIM II severity score had higher mortality rate; [AOR = 35, 95% CI (1.7, 11)]. Conclusions In the current study, the mortality rate of mechanically ventilated pediatric patients was high. Severity score, multi-organ dysfunction syndrome, length of stay, and being a surgical patient increased the risk of mortality. Adequate education of PICU staff on the use of mechanical ventilator and prevention of complications as well as the use of severity score is necessary.

Time to recovery and its predictors among critically ill patients on mechanical ventilation from intensive care unit in Ethiopia: a retrospective follow up study

“…In Ethiopia it is considered as mortality of patients admitted to an ICU is 40% [13]. Also from Ethiopian context, due to lack of resources (ICU beds, Mechanical Ventilators and trained staff ), health personals have difficulties in making decisions [14].…”