https://doi.org/10.4081/monaldi.2023.2506

Impact of neurological problems on mechanical ventilation and intensive care unit outcomes in pulmonary intensive care unit patients: a retrospective analysis of a single-center cohort

Vol. 94 No. 1 (2024)
Submitted: December 9, 2022
Accepted: April 11, 2023
Published: April 19, 2023
Intensive care outcomes, neurological problems, mechanical ventilation
Abstract Views: 680
PDF: 238
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Authors

Zeynep Çınar
zeynepsahin1980@gmail.com
https://orcid.org/0000-0003-3223-543X
Division of Critical Care Medicine, Department of Anesthesiology, Gazi University School of Medicine, Ankara, Turkey.
Eda Macit Aydın
https://orcid.org/0000-0002-4607-4932
Division of Critical Care Medicine, Department of Anesthesiology, Gazi University School of Medicine, Ankara, Turkey.
Nurgul Naurzvai
https://orcid.org/0000-0002-8538-8045
Division of Critical Care Medicine, Department of Pulmonary Medicine, Gazi University School of Medicine, Ankara, Turkey.
Ayshan Mammadova
https://orcid.org/0000-0002-8838-7419
Division of Critical Care Medicine, Department of Pulmonary Medicine, Gazi University School of Medicine, Ankara, Turkey.
Sümeyye Kodalak
https://orcid.org/0000-0002-5174-6457
Division of Critical Care Medicine, Department of Pulmonary Medicine, Gazi University School of Medicine, Ankara, Turkey.
Aygül Abbasova
Division of Critical Care Medicine, Department of Pulmonary Medicine, Gazi University School of Medicine, Ankara, Turkey.
Gül Gürsel
https://orcid.org/0000-0001-9646-1933
Division of Critical Care Medicine, Department of Pulmonary Medicine, Gazi University School of Medicine, Ankara, Turkey.

Neurological problems (NPs) are frequently connected with different critical illnesses in intensive care unit (ICU) patients, and they may influence ICU outcomes. This study aims to examine the effects of NPs on ICU outcomes, especially in pulmonary ICU patients. This is a retrospective observational study comprising adult pulmonary critical care patients who were hospitalized between 2015 and 2019. The frequency of NPs at admission, their impact on mechanical ventilation (MV), ICU outcomes, the rate of NP development during the ICU stay, and risk factors for them were investigated. A total of 361 patients were included in the study, and 130 of them (36%) had NPs (group 1). The noninvasive ventilation requirement rate in patients with NPs was less than in those without NPs (group 2), and the requirement of MV was significantly more frequent in this group (37% and 19%, p<0.05). The duration of MV (19±27 and 8±6 days, p=0.003) and sepsis rate (31% and 18%, p=0.005) were also higher in group 1. NPs developing after ICU admission increased the MV requirement 3 times as an independent risk factor. Risk factors for ICU-acquired NPs were the existence of sepsis during admission [odds ratio (OR): 2.01, confidence interval (CI) 95%: 1.02-4, p=0.045] and longer MV durations before ICU admission (OR: 1.05, CI 95%: 1.004-41.103, p=0.033). NPs were not independent risk factors for mortality (OR: 0.67, CI 95%: 0.37-1.240, p=0.207). NPs did not increase mortality but more frequently caused MV requirement, more extubation failure, and a longer ICU stay in this study population. Additionally, our data suggest that having sepsis during admission and a longer length of MV prior to admission may increase the neurological complication rate.

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Ethics approval

The study was approved by the ethics committee of Gazi University Medical Faculty (ethics committee approval number and date: 868, November 23, 2020).

How to Cite

Çınar, Zeynep, Eda Macit Aydın, Nurgul Naurzvai, Ayshan Mammadova, Sümeyye Kodalak, Aygül Abbasova, and Gül Gürsel. 2023. “Impact of Neurological Problems on Mechanical Ventilation and Intensive Care Unit Outcomes in Pulmonary Intensive Care Unit Patients: A Retrospective Analysis of a Single-Center Cohort”. Monaldi Archives for Chest Disease 94 (1). https://doi.org/10.4081/monaldi.2023.2506.
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