A progressive care programme for prolonged ventilatory failure: analysis of outcome.

Forty consecutive patients who could not be weaned from mechanical ventilation in the intensive care unit (ICU) entered a multidisciplinary progressive care programme (PCP). The mean number of hours per day of ventilatory support was 19.9 at the time of transfer but only 6.7 at discharge. Eleven patients did not require ventilation after discharge, 24 received ventilation non-invasively and only three via a tracheostomy. Survival at discharge from hospital was 90% compared with the predicted survival of 53% from the Apache II scores on admission to the ICU. Seventy-six percent were alive 1 yr after discharge and 80% of patients were discharged directly from the PCP to their homes. Mental and emotional scores in a quality of life questionnaire (SF 36) were normal, but physical function remained limited.