The practice of mechanical ventilation in Kenyatta National Hospital intensive care unit
Abstract
This was a descriptive longitudinal study that was carried out
in Kenyatta National Hospital intensive care unit between January and March 2007.The main
objective of the study was to describe the pattern of ventilatory support to patients admitted in
the ICU.Other objectives included the determination of diagnoses of mechanically ventilated
patients ,the duration of ventilatory support, the weaning outcomes and micro organisms isolated
from tracheal aspirates.
The information obtained from the patients was filled in structured questionnaires by the
principle investigator. Data analysis was done using the SPSS programme and standard statistical
tests applied.
The study revealed that most of the patients were males (64. 1%) with male to female ratio of
1.8:1.Head injuries accounted for almost a third (29.7%) of all patients admitted for mechanical
ventilatory support.27.2% of the patients were referred from the District hospitals. Mechanical
ventilatory support was delivered through translaryngel intubation in 80.5% of the patients. Half
of the patients (50.6%) were successfully weaned from ventilatory support while 4.4% became
ventilator dependent. Pseudomonas aeruginosa was the commonest micro organism isolated
from tracheal aspirates and accounted for 19.8% of all tracheal aspirates that were done. The
commonest complication was tube blockage/displacement (28.8%) while critical incidents were
reported in almost a third of the patients (31. 1%)
The study recommended that better utilization of Acute and Emergency department, intensive
care rooms in medical and surgical wards and post anaesthetic care unit would reduce the
number of referrals to the ICU.Clearly elaborated admission criteria for admission of patients for
mechanical ventilation should be availed and a weaning protocol should be prepared and availed
to all critical care teams.
Citation
Master Of Medicine In Anaesthesiology, University Of Nairobi, 2007Publisher
Universty of Nairobi