Prolonged mechanical ventilation: are you a lumper or a splitter?

In this issue of RESPIRATORY CARE, Kojicic and colleagues describe long-term survival in patients who underwent tracheostomy for anticipated or prolonged mechanical ventilation (PMV) in Olmsted County, Minnesota.1 The study confirmed that approximately 10% of patients with invasive mechanical ventilation undergo tracheotomy and that overall 1-year mortality in that population is still substantial. Older age and the presence of COPD negatively impacted survival, whereas survival was better among neuromuscular patients who continued to receive mechanical ventilation even after discharge. Importantly, Kojicic et al note that chronic conditions that relate to the underlying cause of mechanical ventilation should be taken into account when considering PMV outcomes.