Gursel et al identified a number of risk factors associated with prolonged mechanical ventilation for a patient with chronic obstructive pulmonary disease (COPD) in the intensive care unit (ICU). These can help identify a patient who may require closer monitoring and more aggressive management. The author is from Gazi University School of Medicine in Anakara, Turkey.


General risk factors for prolonged mechanical ventilation:

(1) age >= 69 years of age

(2) admission APACHE II >= 19 (measure of disease severity on admission)

(3) serum albumin on admission <= 3.0 g/dL

(4) development of ventilator-associated pneumonia (VAP)

(5) development of sepsis



• The cutoffs for the first 3 items are guestimates from the date in Table 5.


Risk factors for mechanical ventilation > 7 days:

(1) ventilator-associated pneumonia

(2) sepsis


Risk factors for mechanical ventilation > 15 days:

(1) ventilator-associated pneumonia


Risk factors for mechanical ventilation > 21 days:

(1) age

(2) admission APACHE II score

(3) hypoalbuminemia


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