Your browser doesn't support javascript.
loading
Low mechanical ventilation times and reintubation rates associated with a specific weaning protocol in an intensive care unit setting: a retrospective study
Silva, Cilene Saghabi de Medeiros; Timenetsky, Karina T.; Taniguchi, Corinne; Calegaro, Sedila; Azevedo, Carolina Sant'Anna A.; Stus, Ricardo; Matos, Gustavo Faissol Janot de; Eid, Raquel A.C.; Barbas, Carmen Silvia Valente.
Affiliation
  • Silva, Cilene Saghabi de Medeiros; Hospital Israelita Albert Einstein. Critically III Patients Department. Intensive Care Unit. São Paulo. BR
  • Timenetsky, Karina T.; Hospital Israelita Albert Einstein. Critically III Patients Department. Intensive Care Unit. São Paulo. BR
  • Taniguchi, Corinne; Hospital Israelita Albert Einstein. Critically III Patients Department. Intensive Care Unit. São Paulo. BR
  • Calegaro, Sedila; Hospital Israelita Albert Einstein. Critically III Patients Department. Intensive Care Unit. São Paulo. BR
  • Azevedo, Carolina Sant'Anna A.; Hospital Israelita Albert Einstein. Critically III Patients Department. Intensive Care Unit. São Paulo. BR
  • Stus, Ricardo; Hospital Israelita Albert Einstein. Critically III Patients Department. Intensive Care Unit. São Paulo. BR
  • Matos, Gustavo Faissol Janot de; Hospital Israelita Albert Einstein. Critically III Patients Department. Intensive Care Unit. São Paulo. BR
  • Eid, Raquel A.C.; Hospital Israelita Albert Einstein. Critically III Patients Department. Intensive Care Unit. São Paulo. BR
  • Barbas, Carmen Silvia Valente; Hospital Israelita Albert Einstein. Critically III Patients Department. Intensive Care Unit. São Paulo. BR
Clinics ; 67(9): 995-1000, Sept. 2012. ilus, tab
Article in English | LILACS | ID: lil-649375
Responsible library: BR1.1
ABSTRACT

OBJECTIVES:

A number of complications exist with invasive mechanical ventilation and with the use of and withdrawal from prolonged ventilator support. The use of protocols that enable the systematic identification of patients eligible for an interruption in mechanical ventilation can significantly reduce the number of complications. This study describes the application of a weaning protocol and its results.

METHODS:

Patients who required invasive mechanical ventilation for more than 24 hours were included and assessed daily to identify individuals who were ready to begin the weaning process.

RESULTS:

We studied 252 patients with a median mechanical ventilation time of 3.7 days (interquartile range of 1 to 23 days), a rapid shallow breathing index value of 48 (median), a maximum inspiratory pressure of 40 cmH(2)0, and a maximum expiratory pressure of 40 cm H(2)0 (median). Of these 252 patients, 32 (12.7%) had to be reintubated, which represented weaning failure. Noninvasive ventilation was used postextubation in 170 (73%) patients, and 15% of these patients were reintubated, which also represented weaning failure. The mortality rate of the 252 patients studied was 8.73% (22), and there was no significant difference in the age, gender, mechanical ventilation time, and maximum inspiratory pressure between the survivors and nonsurvivors.

CONCLUSIONS:

The use of a specific weaning protocol resulted in a lower mechanical ventilation time and an acceptable reintubation rate. This protocol can be used as a comparative index in hospitals to improve the weaning system, its monitoring and the informative reporting of patient outcomes and may represent a future tool and source of quality markers for patient care.
Subject(s)


Full text: Available Collection: International databases Database: LILACS Main subject: Respiration, Artificial / Ventilator Weaning / Intubation, Intratracheal Type of study: Practice guideline / Observational study / Prognostic study / Risk factors Limits: Adult / Aged / Aged, 80 and over / Female / Humans / Male Country/Region as subject: South America / Brazil Language: English Journal: Clinics Journal subject: Medicine Year: 2012 Document type: Article Affiliation country: Brazil Institution/Affiliation country: Hospital Israelita Albert Einstein/BR

Full text: Available Collection: International databases Database: LILACS Main subject: Respiration, Artificial / Ventilator Weaning / Intubation, Intratracheal Type of study: Practice guideline / Observational study / Prognostic study / Risk factors Limits: Adult / Aged / Aged, 80 and over / Female / Humans / Male Country/Region as subject: South America / Brazil Language: English Journal: Clinics Journal subject: Medicine Year: 2012 Document type: Article Affiliation country: Brazil Institution/Affiliation country: Hospital Israelita Albert Einstein/BR
...