Resuscitation Preferences in Survivors of Prolonged Mechanical Ventilation (PMV)/Tracheostomy
Background: Resuscitation preferences regarding prolonged mechanical ventilation (PMV) have rarely been explored. Objectives: To determine preferences of PMV survivors and influencing factors. Methods: Subjects were 29 (57% male) survivors of PMV ( 7 days) and tracheostomy interviewed > 6 weeks after MV was initiated. Subjects were asked to: 1) indicate if they would choose MV again; 2) rate present health, pain/discomfort in ICU and from MV, perceived family financial burden and emotional/physical stress using a Likert scale (0=positive, 4=negative); 3) identify change changes that might alter this preference; and 4) complete questionnaires assessing quality of life (QoL) (SF-36), functional status (Health Assessment Questionnaire), depressive symptoms (Center for Epidemiological Studies Depression Scale) and communication (Patient Communication Survey). Results: Most (76%) would undergo PMV again. Median MV days were greater for those who would undergo MV again (98.5 vs. 70, p=NS), as were median tracheostomy days (102 vs. 64, p=NS). Those who would not undergo MV again were more likely to have depressive symptoms (p=0.051) and Medicare coverage (p=0.023). No other variables differed between groups, including age, ICU length-of-stay, QoL, functional status, or communication status. Individuals who preferred MV stated their preference would change if their health and/or the family s emotional/physical stress were worse. Those who did not prefer MV would change if family s financial burden and emotional/physical stress were reduced. Conclusions: Most patients would undergo PMV again despite substantial time on MV. Preferences were most likely to change based on present health and family s financial burden and stress.
Advisor:Lakshmipathi Chelluri, MD; Mary Beth Happ, RN, PhD; Annette DeVito Dabbs, RN, PhD; Yookyung Kim, PhD; Leslie A. Hoffman, RN, PhD
School:University of Pittsburgh
School Location:USA - Pennsylvania
Source Type:Master's Thesis
Date of Publication:12/17/2004