Abstract
Aim: RICUs are designed to treat invasive mechanical ventilated (IMV) stable patients for weaning and chronic care, hemodinamically stable patients with compromised gas exchange for frequent observation and/or non-invasive ventilation (NIV) and patients who require frequent vital signs monitoring or aggressive pulmonary physiotherapy. We aimed to evaluate the work developed in our RICU.
Methods: A systematic retrospective review was made from February 1 to July 31, 2010, in an 8 beds RICU.
Results: In the studied period, 105 patients were responsible for 126 admissions, 73% were male, mean age was 68 yrs. (16-96). Patients were referred mainly from the Emergency Department (44%), Intensive Care Unit (ICU) (21%) and Respiratory wards (11%). The reasons for admission were in 21% to step-down ICU, 52% for NIV, 24% for cardiorespiratory monitoring and 3% for other reasons. In 98% respiratory insufficiency was present, mainly hypercapnia, mostly caused by infectious respiratory exacerbations. All but 1 had chronic disease, 76% cardiac and 60% pulmonary (mostly severe). The average stay at RICU was 22 days (1-76). RICU has enabled to liberate 536 days of ICU. Eleven patients were transferred to ICU and 20 died. One of two was weaned from chronic IMV. Tracheotomy was closed in 3 of 5 patients. In respiratory failure patients, NIV succeeded in 46 (70%), 4 were transferred to ICU and 16 patients under palliative NIV died.
Conclusions: Despite the diversity of work developed in our RICU, primarily it allowed free days in ICU and NIV practice. Although the advanced stage of chronic diseases and a high number of do not intubate patients, the possibility of close monitoring and observation is greatly responsible for NIV's success.
- © 2011 ERS