Objective: To identify incidence, outcomes and risk factors of prolonged acute mechanical ventilation (PAMV) in surgical patients admitted to surgical intensive care units (ICUs) of two large academic hospitals in Thailand.
Material and Method: This is a retrospectively analyses of the THAI-SICU database which is a multi-center, prospective, observational cohort study to identify the adverse events and mortality in surgical ICUs. The new term PAMV was defined as the requirement of mechanical ventilation for longer than 4 days.
Results: A total of 1,084 patients were included in this study. The incidence of PAMV in this cohort was approximately 40%. PAMV patients demonstrated significantly higher percentage of clinical complication including stroke, seizure, sepsis, upper gastrointestinal hemorrhage, acute kidney injury and adult respiratory distress syndrome (ARDS)/acute lung injury (ALI) than patients who required mechanical ventilation <4 days. Sepsis, non-operative and controlled mechanical ventilation on admission were identified as independent risk factors for PAMV. Patients who had sepsis were 3.2 times higher risk associated with PAMV (adjusted odds ratio (OR) 3.25, 95% confidence interval (CI) 2.25 to 4.7) and patients who were non-operative and on controlled mechanical ventilation (CMV) on admission were approximately 2.5-fold higher risk associated with PAMV.
Conclusion: The incidence of PAMV was 40% in surgical ICU patients. The mortality and complication rate were higher in PAMV patients.

Keywords: Prolonged mechanical ventilation, Acute, Surgical patients, Intensive care unit, Mortality