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Critical incidents related to invasive mechanical ventilation in the ICU: preliminary descriptive study
I Auriant1, J Reignier, M L Pibarot
1Surgical Respiratory Intensive care Unit, Marie lannelongue Surgical Center, le Plessis Robinson, France. auriant@ccml.com
Objectives:
To establish a preliminary list of critical incidents (CIs) associated with mechanical ventilation and to describe a CI reporting method.
Design:
A list of CIs was established based on a consensus among ICU caregivers. The list was compared to CIs collected prospectively during a predefined study period.
Setting:
The clinical observations were conducted in two intensive care units.
Patients:
All patients receiving mechanical ventilation were included.
Measurements And Results:
The list of CIs included death and 62 other CI types categorized as immediately life-threatening, secondarily life-threatening, or non-life-threatening. The observational study identified 527 CIs in 137 patients. Virtually all non-life-threatening CIs were ascribed to failure to comply with safety rules or to equipment failure and 40% of life-threatening CIs to the course of the disease or to patient-related factors. The match between CI types on the list and CI types observed in the ICUs was excellent.
Conclusions:
Use of our reporting method to create a CI database in a multicenter study including ICUs with varying recruitment patterns may help to identify markers suitable for routine continuous use as part of a quality-assurance program.