The Mayo Ventilator-Dependent Rehabilitation Unit: A 5-year experience

Objective: To describe the outcomes of 206 patients admitted to the Mayo Ventilator-Dependent Rehabilitation Unit (VDRU) during a 5-year study period. Design: We analyze the patient data for 1990 through 1994, which had been prospectively entered into a computer database for a cohort of 206 patients who had become ventilator dependent during their current hospitalization. Material and Methods: Patients in the VDRU were classified into one of six categories that reflected the reasons for ventilator dependence. Ability to be weaned from mechanical ventilation, duration of hospital stay and ventilator dependence, outcome, disposition, demographics, and long-term survival were analyzed. The VDRU patient group was compared for hospital and follow-up outcomes with a group of historical control patients previously described by us. Results: The Mayo VDRU was established in January 1990. During the first 5 years of its operation, 206 newly ventilator-dependent patients were admitted to the VDRU, 190 (92%) of whom survived to be dismissed; 16 patients (8%) died in the hospital, Of the 190 patients dismissed, 77% were able to return to their homes. Overall, 153 patients were liberated from mechanical ventilation, whereas 37 remained either completely or partially ventilator dependent. Of these 37 patients, 27 (73%) were receiving nocturnal mechanical ventilation only. The 4-year survival was 53%. Conclusion: The Mayo VDRU has been highly successful in liberating newly ventilator-dependent patients from mechanical ventilation. The longterm survival after management in the VDRU has been excellent. In addition, the medical charges for care in the VDRU are less than intensive-care unit charges.