Utilización de la ventilación mecánica en 72 unidades de cuidados intensivos en España

Background. Mechanical ventilation is a fundamental technique in the intensive care unit (ICU). The objective of this study was to determine the utilization of this technique and whether there are differences in its application in 72 ICUs in Spain. Methods. A cohort study of patients who underwent mechanical ventilation for more than 12 hours was performed. We collected demographic data, indication for mechanical ventilation, ventilatory parameters, modes of ventilation and weaning, days of ventilatory support, hospital stay, and status at discharge. Results. A total of 1,103 inpatients (29%) required mechanical ventilation. Sixty-six percent were men. The median age was 65 years. The median Simplified Acute Physiology Score (SAPS) II was 43. No geographical differences were observed regarding the implementation of mechanical ventilation or regarding the main outcomes. In 64% of patients the indication was acute respiratory failure. Initially, the assisted-controlled mode was the most frequently used (90%), with a tidal volume of 8.9 (2.0) ml/kg and a PEEP of 5.5 (2.2) cmH₂O. Four percent of patients underwent non-invasive ventilation, and 68% did not require intubation. Duration of ventilation was 7 (8) days. The most commonly used weaning method was a once daily test of spontaneous breathing (58%). Duration of weaning was 3 (5) days. Tracheostomy was performed in 15% of patients and was carried out at 14 (8) days. Mortality in the ICU was 32.8% and inpatient mortality was 42.8%. Conclusions. Comparison of the utilization of mechanical ventilation in 72 Spanish ICUs showed similar practices. Differences in the use of modes of ventilation and weaning were minimal and mortality and length of stay were similar.