Prolonged acute mechanical ventilation: implications for hospital benchmarking

Prolonged acute mechanical ventilation: implications for hospital benchmarking. CHEST May 2009, vol. 135 no. 5 1157-1162 [journal article]

Zilberberg, M.D., Kramer, A.A., Higgins, T.L., Shorr, A.F.

http://www.chestjournal.org/content/135/5/1157.short?rss=1

Hospital performance measures rely on aggregate outcomes. For patients receiving mechanical ventilation (MV), outcomes depend on severity of illness, hospital MV volume, and case mix. Patients requiring prolonged acute MV (PAMV) [MV for ≥ 96 h] comprise a resource-intensive group, but the impact of its volume on aggregate outcomes is unknown.

End of life care - nineteenth report of session 2009/09

End of life care - nineteenth report of session 2008/09. House of Commons, Public Accounts Committee, March 2009.

http://www.publications.parliament.uk/pa/cm200809/cmselect/cmpubacc/99/99.pdf

This report examines the scale and quality of end of life care, the current and future approach to commissioning and funding of services, and the capability and capacity of NHS and social care staff to provide such care.

Weaning patients off invasive ventilation

Weaning patients off invasive ventilation. [editorial] BMJ 2009; 338:b728

http://www.bmj.com/cgi/content/full/338/may21_1/b728

At any given time, 30-70% of patients in the intensive care unit (ICU) are receiving mechanical ventilatory support; 70-80% of them are rapidly weaned off this support, often within a few days. Weaning is more problematic in the remaining 20-30% of patients, usually because of unfavourable respiratory mechanics, residual disease processes, cardiac dysfunction, respiratory muscle weakness, high secretion volumes, or altered mental status.