Relationship between Ventilator-Associated Events and Timing of Rehabilitation in Subjects with Emergency Tracheal Intubation at Early Mobilization Facility

• Published in: International journal of environmental research and public health Vol. 15; no. 12; p. 2892
• Main Authors: Shinoda, Taku, Nishihara, Hiromasa, Shimogai, Takayuki, Ito, Tsubasa, Takimoto, Ryuya, Seo, Ryutaro, Kanai, Masashi, Izawa, Kazuhiro P., Iwata, Kentaro
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 17.12.2018; MDPI
• Subjects: Aged; Aged, 80 and over; Body mass index; Early Ambulation - statistics & numerical data; Edema; Female; Hospitalization; Humans; Information sharing; Intensive Care Units - statistics & numerical data; Intervention; Intubation; Male; Medical records; Middle Aged; Mortality; Ostomy; Patient safety; Pneumonia; Rehabilitation; Respiration, Artificial - adverse effects; Surveillance; Time Factors; Tracheotomy; Ventilators; Weaning; Japan; timing of rehabilitation; rehabilitation protocol; retrospective research; ventilator-associated events; early mobilization; intubated trachea
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph15122892

The present study aimed to investigate the relationship between the occurrence of ventilator-associated events (VAE) in the intensive care unit and the timing of rehabilitation intervention. We included subjects who underwent emergency tracheal intubation and received rehabilitation. We performed rehabilitation according to our hospital’s protocol. We assessed the mechanical ventilation parameters of inspired oxygen fraction and positive-end expiratory pressure, and a VAE was identified if these parameters stabilized or decreased for ≥2 days and then had to be increased for ≥2 days. We defined time in hours from tracheal intubation to the first rehabilitation intervention as Timing 1 and that to first sitting on the edge of the bed as Timing 2. Data were analyzed by the t-test and χ2 tests. We finally analyzed 294 subjects. VAE occurred in 9.9% and high mortality at 48.3%. Median values of Timing 1 and Timing 2 in the non-VAE and VAE groups were 30.3 ± 24.0 and 30.0 ± 20.7 h, and 125.7 ± 136.6 and 127.9 ± 111.4 h, respectively, and the differences were not significant (p = 0.95 and p = 0.93, respectively). We found no significant relationship between the occurrence of VAE leading to high mortality and timing of rehabilitation intervention.