Practical Artificial Ventilation in an African Tropical Environment: Experience of the Intensive Care Unit of the University Hospital of Treichville

摘要

Objective: To describe the practice of artificial ventilation (VA) in a resuscitation unit of a developing country with a view to its improvement. Patients and Methods: Prospective study for descriptive and analytical purposes, carried out in the intensive care unit of the University and Hospital Center of Treichville (Ivory Coast) from April 2009 to June 2010. All the patients having benefited from a artificial ventilation for a duration greater than 6 hours were included in this study. The studied parameters were: Socio-demographic (age, sex), diagnostic, therapeutic (indications, duration and complications of artificial ventilation), evolutionary. Results: Out of a total of 204 admissions during the study period, 81 patients received artificial ventilation, an incidence of artificial ventilation in the order of 39.7%. There were 49 men and 32 women. The ventilated patients had an average age of 43.9 years (range: 4 years and 85 years). Pathologies requiring artificial ventilation were neurological (46%) and traumatic (28%). Stroke was the leading medical condition (65%) while polytrauma was the major traumatic condition (65%). The most commonly used ventilatory modes were controlled volume ventilation (52.4%) and assisted ventilation (34.9%). The mean duration of artificial ventilation was 5.98 ± 3.73 days (range: 1 day and 21 days). The nosocomial pneumonia acquired under mechanical ventilation (PAVM) constituted 27% of the complications observed under artificial ventilation. The average length of ICU stay for all ventilated patients was 9.85 +/- 7.51 days (range: 1 day and 31 days). The lethality in our series was 80%. Patient age was the only prognostic factor associated with death (P = 0.003). Conclusion: The practice of artificial ventilation is still difficult in Ivory Coast and is at the origin of many complications such as nosocomial pneumonia acquired under mechanical ventilation which complicate the life threatening of the patients.