Long-Term Outcome after Prolonged Mechanical Ventilation. A Long-Term Acute-Care Hospital Study

Area of Science:

• Critical Care Medicine
• Pulmonology
• Rehabilitation Medicine

Background:

• Prolonged mechanical ventilation in long-term acute-care hospitals (LTACH) is associated with significant muscle weakness and disability.
• Assessing the long-term impact on survival, muscle function, and quality of life is crucial for patient recovery.

Purpose of the Study:

• To investigate the effects of prolonged ventilation on survival.
• To evaluate muscle function and its impact on quality of life at 6 and 12 months post-LTACH discharge.

Main Methods:

• A prospective, longitudinal study involving 315 patients undergoing weaning from prolonged ventilation at an LTACH.
• Measurements included maximum inspiratory pressure (Pi_max), handgrip strength, Katz activities-of-daily-living score, and the 36-item Short-Form Survey.

Main Results:

• At discharge, 53.7% of patients were weaned from the ventilator, with a 1-year survival rate of 66.9%.
• While respiratory strength (Pi_max) was maintained, peripheral strength (handgrip) was severely impaired but improved significantly post-discharge.
• Improvements in handgrip strength correlated with enhanced daily living activities, and quality of life scores returned to pre-illness levels by 12 months.

Conclusions:

• A significant portion of patients can be weaned from mechanical ventilation, with a notable 1-year survival rate.
• Peripheral muscle function recovery is key to improving daily activities and quality of life after LTACH.
• Despite the challenges, a high percentage of survivors expressed willingness to undergo mechanical ventilation again if necessary.