[Development of a quality guarantee system for mechanical ventilation (register in a multi-purpose CCU)].

OBJECTIVE: 1. Obtaining information about the demographic distribution of patients undergoing long-term mechanical ventilation. 2. Defining our reference standards for mechanical ventilation, length of UCC and complications related to mechanical ventilation (MV), comparable with the international standards. Detailed follow-up of pneumonias associated to mechanical ventilation and incidence of accidental extubation (AE). DESIGN: Prospective, descriptive. Period between July 1998 and December 2000. AREA OF STUDY: Multi-purpose critical care unit (12 beds). INDIVIDUALS UNDER STUDY: Patients hospitalized in the critical care unit with any pathology in need of mechanical ventilation. RESULTS: During the period of study 1058 patients were hospitalized in the critical care unit (CCU), 287 (27%) of which needed mechanical ventilation (MV). 29% of the patients were women. The age and APACHE II were as median (percentile 25 and 75) 68 (57-76) and 26 (20-31) respectively. The reasons that made MV necessary were: acute respiratory failure 70%, intensified acute exacerbation of chronic respiratory failure 11%, coma 18% and neuromuscular illness 1%. The density of average incidence of accidental extubation (AE) was 15.7/1000 days of MV, the AE was associated to a longer duration of MV, longer stay in CCU and in the hospital and a greater incidence of pneumonia associated to MV, but it was not associated to an increment in mortality. The density of incidence of pneumonia associated to MV was 12.6/1000 days of MV, being the germ more frequently responsible the pseudomona aeruginosa.