OUT COME AND ASSOCIATED FACTORS OF INTUBATED AND MECHANICALLY VENTILATED PATIENTS AT SPHMMC AND AaBET HOSPITAL EMERGENCY AND INTENSIVE CARE UNIT, ADDIS ABABA, ETHIOPIA

Abstract

Abstract Introduction: Intubation and mechanical ventilation is a lifesaving therapy, allowing the support of patients with respiratory failure and coma with the objectives of improving gas exchange and decreasing work of breathing. Objective: To assess the outcome and associated factors of intubated and mechanically ventilated patients in SPHMMC and AaBET hospital emergency and intensive care unit from June 1 2021 to May 30 2022 G.C Methodology The study was conducted in SPHMMC and AaBET hospital by using a cross sectional study design over one year. Systematic random sampling technique was used to get required samples from database. Data was entered and exported to SPSS for analysis. Bivariate and multivariate logistic regression was used to analyze the association between dependent and independent variables. Result: From 384 patients who met the inclusion criteria 233 (58.1%) were male and 161 ((41.9%) were females. Majority of patients 212 (55.2%) who were intubated and mechanically ventilated were medical patients.The final outcome were 167 (43.5 %) discharged and 217 (56.5 %) were died. The immediate cause of death for majority patients 103 (47.46%) were refractory septic shock. The indication for intubation for majority 214 (55.7 %) were for coma or air way protection.Mostly used machine mode as weaning method was CPAP 101 (50 % ). Mostly used sedative agent during mechanical ventilator support was ketofol for 180 (46.9 %) patients. Rapid sequence intubation was the most commonly used procedure during intubation in 270 (70.3 %) of patients. Most commonly seen mechanical ventilator support related complication was reintubation 42 (10.9 %).Most common complication due to prolonged intubation was Laryngeal edema in 100 (26 %) patient. Most common complication due to prolonged hospital stay was HAP – VAP 134 (34.9 %) patients. Conclusion: The survival of intubated and mechanically ventilated patients at AaBET and SPHMMC Adult emergency and critical care unit in this study was poor. This is due to patients who need intubation and mechanical ventilation are in refractory septic shock and others are severe traumatic brain injury who have poor prognosis at initial presentation who develop multiple complication. Key word: Assessment, mechanical ventilation, Intensive Care Unit, intubation, outcomes.