Mechanical Ventilation: Relationship Between Body Mass Index and Selected Patients’ Outcomes at a University Hospital in Cairo

Abstract

Background: Mechanical ventilation is a life-saving management approach for critically ill patients. However, it has certain negative consequences which may affect patients' outcomes. Among factors that could adversely influence the prognosis of these patients is the body mass index (BMI). Aim of the study: to investigate the relationship between BMI and selected outcomes of critically ill mechanically ventilated patients. Research Design: A descriptive correlational research design was utilized Research questions: a) what is the BMI profile of mechanically ventilated patients admitted to critical care units over a period of six months? b) What is the relationship between body mass index and frequency of organ dysfunction, length of ICU stay, weaning from mechanical ventilation, and the mortality rate among adult critically ill mechanically ventilated patients? Setting: different intensive care units of a university hospital in Cairo. Sample: A purposive sample of 30 critically ill patients connected to mechanical ventilators for at least 72 hours. Tools of data collection: Three tools were utilized to collect data pertinent to the current study: tool 1: patients’ demographic and medical data, tool 2: BURNS Wean Assessment Program (BWAP) checklist, tool 3: Sequential Organ Failure Assessment (SOFA score) tool. Results: More than three quarters (77%) of the studied sample were males, and more than one quarter (26.7 %) were in the age group of 18-28 and 40-50 years old respectively, with a mean age of 39.766 ± 13.51. Two thirds (66.7%) of the studied sample had normal BMI. No significant statistical relationship was found between BMI and ICU length of stay and mortality rate among the studied sample, (X²= 11.31, P value < 0.79), (X² = 0.15, P value < 0.928) respectively. No significant statistical relationship was found between BMI and the weaning trials from mechanical ventilation (X²= 0.15, P value < 0.928). No significant statistical relationship was found between BMI and the occurrence of organ dysfunction (X² = 2.54, P value < 0.637). Conclusion: BMI in the current study was not found to have relationship to weaning from MV, length of ICU stay, occurrence of organ failure, and mortality rate. Recommendations: Nutritional status of critically ill mechanically ventilated patients must be considered in their management; meticulous nutritional assessment must be done for all critically ill mechanically ventilated patients to enable in monitoring their progress and outcomes; development of a comprehensive assessment tool that facilitates inspection and early detection of problems/complications among mechanically ventilated patients' documentation system must include patients' nutritional assessment data such as anthropometric measurements (height, weight) to facilitate calculation of BMI.

Keywords: Mechanical ventilation, body mass index, organ dysfunction, length of ICU stay, weaning from mechanical ventilation, mortality rate