Fatores associados ao desmame ventilatório em pacientes internados em unidade de terapia intensiva adulto em hospital universitário

Abstract

Introduction: In intensive care units, it can be found a high incidence of patients undergoing intubation and mechanical ventilation. Weaning from mechanical ventilation is indicated as early as clinically possible, due to the complications associated with the use of positive pressure used in invasive mechanical ventilation. Several weaning protocols have been created to predict the success of extubation. However, it is necessary to identify the factors that interfere with failure of ventilatory weaning. Objective: Our aim was to identify the factors associated with failure and success of ventilatory weaning in patients who were admitted to the adult intensive care units of a university hospital. Method: Cross-sectional study in which the factors associated with failure of ventilatory weaning were investigated in individuals of both genders, 18 years of age or older, submitted to orotracheal intubation and invasive mechanical ventilation for more than 24 hours, admitted in the Adult intensive care units of university hospital. Descriptive analyses of the demographic and clinical variables of the individuals were performed. Crude and adjusted logistic regression analyses (95%CI) of the occurrence of failure in extubation in the sample were also performed. Results: There was an association between failure in ventilatory weaning and tracheostomy (OR: 8,06; IC95%: 1,50-43,31) death (OR: 5,53; IC95%:1,67-18,25) and length of stay in the intensive care unit OR: 1,05: IC95%: 1,00-1,12) . Most patients were male, aged over 60 years, the main reason for orotracheal intubation was acute respiratory failure, pneumological diagnosis. Among the patients included in the study, 154 (70.3%) had at least one extubation attempt and of these 20 (13.1%) had extubation failure. Conclusion: Ventilatory weaning failure is associated with tracheostomy, death and length of stay in the ICU among patients. These findings reinforce the need to implement ventilatory weaning protocols and assess patients at risk of extubation failure.