The duration of mechanical ventilation in patients with chronic obstructive pulmonary disease and acute respiratory distress syndrome admitted to the intensive care unit: Epidemiological findings from a tertiary hospital

Fatmah M Othman1, Yassin T Ismaiel2, Saad A Alkhathran3, Abdulaziz S Alshamrani3, Meshal A Alghamdi3, Taha Ismaeil4
1Research Unit, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
2Department of Respiratory Therapy, King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
3Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
4King Abdullah International Medical Research Center; Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
DOI: 10.4103/jnsbm.JNSBM_188_19

ABSTRACT

Context: Data for examining the duration and risk factors associated with the length of hospital stay with mechanical ventilation (MV) in patients with acute respiratory distress syndrome (ARDS) and chronic obstructive pulmonary disease (COPD) are scarce. Aims: The aim of the study was to examine the hospital stay duration with MV in such patients in the intensive care unit (ICU). Settings and Design: This cross-sectional study was conducted at King Abdulaziz Medical City in Riyadh between 2016 and 2018. Subjects and Methods: Adult patients with ARDS or COPD admitted to the ICU and receiving MV were included in the study. Their medical records were reviewed for information regarding the length of hospital stay, demographic profile, and comorbidity. Results: In total, 136 and 95 patients with ARDS and COPD, respectively, were admitted and received MV. The mean (standard deviation) age of patients with ARDS and COPD was 53 (19) and 68 (12) years, respectively. The patients with COPD had a higher obesity rate (61% in the obese category), higher mean Acute Physiology, Age, Chronic Health Evaluation (APACHE) II score (23.5 vs. 22.7), and preexisting chronic respiratory disease than those with ARDS. The median (interquartile range) MV duration in patients with ARDS was 7 (2–13) days, which was higher than that in patients with COPD (4 [1–9] days). Conclusions: Age, APACHE II score, and preexisting comorbidity contributed to the increase in the length of hospital stay with MV among patients with ARDS. Clinicians must consider such factors before using MV to improve patient outcomes.

Keywords: Acute respiratory distress syndrome, chronic obstructive pulmonary disease, intensive care unit, mechanical ventilation.

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