The aim of the study was to investigate the outcome of prolonged ventilated patients after their transferal from intensive care units (ICU) to the step-down respiratory care center (RCC) in Taiwan.
This was a retrospective observational study in a step-down RCC. Adult patients who was admitted to RCC from October 2000 to September 2001 were eligible for the study. Admission criteria of RCC included age >17 years old, MV for >14 days, arterial oxygenation >60mmHg with the fraction of inspired oxygen (FiO2)<0.55, and positive end-expiratory pressure of <10 cmH2O. The primary outcome was the survival in the RCC and after discharge from the RCC.
Total 224 cases were eligible for the survey, and 108(48.2%) patients were successfully liberated in the RCC. Those who failed weaning had a longer stay in the ICU and RCC (25.1 vs. 20.9 days, and 31.4 vs. 18.6 days with p<0.05). After discharge from the RCC, another 4.9% of the failed patients were weaned within the one year. Patients who failed weaning in RCC had a shorter survival time (5.2 vs. 10.4 months, p<0.05) and a lower one-year survival (23.6% vs. 44.6%, p<0.05).
Patients who were transferred to RCC were still in critical condition, and 25% of these patients died during their stay in the RCC. However, a step-down RCC cound offer a continual care of these pronlonged ventilated (PMV) patients who could not be weaned when in ICU with a reduced cost and resource. Establishing a functional position of step-down RCC in selected PMV patients can be cost-effective.
Early transfer of stable PMV patients to RCC can be cost-effective.
Fung Lin, None.