You could be reading the full-text of this article now if you...

If you have access to this article through your institution,
you can view this article in

Quality of life in survivors of prolonged mechanical ventilatory support

Chatila, Wissam MD; Kreimer, Diane T. RN, RRT; Criner, Gerard J. MD, FCCP

Critical Care Medicine:
Clinical Investigations
Abstract

Objective: To examine the long-term quality of life (QOL) in a group of patients after prolonged mechanical ventilatory support.

Design: Prospective cohort study.

Setting: Outpatient follow-up.

Patients: Survivors of prolonged mechanical ventilatory support who were discharged from a ventilator rehabilitation unit (VRU).

Interventions: Measurement of health-related QOL using the Sickness Impact Profile (SIP).

Measurements and Main Results : Forty-six patients were contacted approximately 2 yrs after their discharge from the VRU and asked to complete the SIP. Twenty-five patients (age, 59 ± 17 yrs; duration of mechanical ventilatory support, 45 ± 36 days [mean ± sd]) agreed to participate in this study and completed the SIP questionnaire 23 ± 18 months after their discharge from the VRU. Patients’ VRU stay was 29 ± 21 days. Two patients were discharged with nocturnal ventilatory support, and the rest were completely weaned of mechanical ventilatory support before discharge. Fifteen patients (60%) were discharged to home, eight patients (32%) were discharged to a rehabilitation facility, and two patients (8%) were discharged to a skilled-care facility. Most patients had mild dysfunction, and the global SIP score was 12 ± 10, the physical dimension score was 12 ± 12, and the psychosocial dimension score was 9 ± 11 (SIP scores range from 0 to 100, with higher scores indicating worse QOL). Subgroup analysis showed that postoperative patients had lower SIP scores compared with patients with chronic respiratory diseases (global SIP, 7 ± 6 vs. 19 ± 8;p < .05). Moreover, the patients in the postoperative group were older, but had similar SIP scores as patients who had acute lung injury (17 ± 15). Global SIP scores correlated with age (r = −.40;p = .046), but not with duration of mechanical ventilatory support (r = −.23) or VRU admission Acute Physiology and Chronic Health Evaluation II scores (r = −.39;p = .06).

Conclusions: In survivors of prolonged mechanical ventilatory support, using specific selection criteria shows that there is minimal impairment in the QOL at long-term follow-up. Although some patients continue to have moderate to severe limitations, it is the cause of respiratory failure and the underlying disease, rather than duration of ventilatory support, that have a significant impact on QOL.

Author Information

From the Division of Pulmonary and Critical Care Medicine, the Department of Medicine, Temple University School of Medicine, Philadelphia, PA.

Supported, in part, by a grant from the Health Care Financing Administration (29-P-99401/3-01).

Address requests for reprints to: Wissam Chatila, MD, Assistant Professor of Medicine, Division of Pulmonary and Critical Care Medicine, 7 PP, Temple University School of Medicine, 3401 N Broad Street, Philadelphia, PA 19140. E-mail: wissam@pol.net

Our data demonstrate that prolonged ventilatory support does not preclude adequate recovery and good self-reported quality of life in selected intensive care unit patients.

© 2001 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins