Research Information System
Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi Üniversitesi, Tıp Fakültesi, Turkey
Approval Date: 2016
Student: EMRE YAŞAR
Supervisor: MELDA TÜRKOĞLU
Abstract:Mechanical ventilation is a significant and essential supportive treatment method for intensive care units. However, it is also risky treatment that could cause fatal complications for many patients. The purpose of this study is to reveal general features of patients that are treated by invasive mechanical ventilation, developing complications, weaning rates, mortality and the factors that are effective on mortality at the intensive care unit of a university hospital. In this study, data of 418 patients, that are treated by invasive mechanical ventilation and stayed more than 24 hours at internal diseases intensive care unit of Gazi University Research Hospital between 01.01.2011 and 31.12.2014, is investigated retrospectively. The most frequent cause of invasive mechanical ventilation is determined as pneumonia of patients. Applied mechanical ventilation mode is %80 assist controlled ventilation, %19 pressure controlled ventilation mode, one patient SIMV mode, one patient pressure support ventilation mode. Median of tidal volume applied at the first day of invasive mechanical ventilation is 480 ml, median of PEEP is 5 cm H2O, median of peak pressure is 26 cm H2O. Among 197 patients that are treated by noninvasive mechanical ventilation, 104 (%53) of them before, 43 (%22) of them after, 50 (%25) of them before and after. Sepsis is observed at 217 (%52) patients, acute renal failure that required renal replacement treatment is observed at 195 (%47) patients, pneumonia is observed at 142 (%34) patients, gastrointestinal bleeding is observed at 42 (%10) patients, ARDS is observed at 24 (%6) patients, pneumothorax is observed at 8 (%2) patients, subcutaneous emphysema is observed at 4 (%1) patients. Among 418 patients that are treated by invasive mechanical ventilation, 304 (%72) of them died, 10 (%2) of them are discharged with tracheostomies and 101 (%24) of them are discharged healthy after successful weaning. 3 (%1) patients left the intensive care unit before the end of weaning trial. For these patients, admission to intensive care units with the reason of sepsis-shock, development of sepsis and acute renal failure that required renal replacement treatment at invasive mechanical ventilation are determined as the independent factors that increased the mortality (respectively p=0.000, p=0.004, p=0.069). Successful weaning of patients is observed as the independent factor that decreased mortality. To conclude, invasive mechanical ventilation is a frequently used treatment at intensive care unit. Mortality and morbidity is high. While developing complications during this treatment increases the mortality, successful weaning is the most significant factor that decreases the mortality.