Post-Icu Mechanical Ventilation at 23 Long Term Care Hospitals: A Multicenter Outcomes Study.

Scheinhorn, David J.; Stearn-Hassenpflug, Meg; Chao, David F.; Doig, Gordon S.; Epstein, Scott K.; Knight, Bert; Petrak, Richard A.; Pitt, Ellen A.; Votto, John

doi:10.1097/00003246-200512002-00080

Cited by 72 publications

(130 citation statements)

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“…11 Furthermore, the success rate is even better if we eliminate from this figure the patients in whom weaning is impossible because of the degree of severity of SCI (29 out of 35, 82.8%). The weaning process in our patients is slow because of the need of retraining and strengthening of the undamaged respiratory muscles (in our series, average was 47.3 days, median 25, versus 29 days of average in patients with neuromuscular diseases 10 or 12.5-15 days in unselected patients), 16,17 and it is similar to other series of SCI patients (26.6-56 days). 5,12 Regarding destiny on discharge, home discharge in the case of SCI patients with the need of respiratory support is always difficult, as they need relatively sophisticated equipment and the clinical situation must be stable to be looked after by the caretaker(s).…”

Section: Discussionsupporting

confidence: 79%

An intermediate respiratory care unit for spinal cord-injured patients. A retrospective study

Romero-Ganuza¹,

García-Forcada²,

Vargas

et al. 2015

Spinal Cord

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Section: Discussionsupporting

confidence: 79%

An intermediate respiratory care unit for spinal cord-injured patients. A retrospective study

Romero-Ganuza¹,

García-Forcada²,

Vargas

et al. 2015

Spinal Cord

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“…In a multicenter study, Scheinhorn et al examined weaning outcomes in post-ICU ventilated patients, and reported a weaning rate of 54.1% and a mortality rate of 25%, which are similar to the results from our control subjects. 1 However, the 75% weaning rate and 0% mortality rate in our training group are considered to be better outcomes, when compared with previous reports. Although quality of life was not assessed in this study, one can assume that patients in a training group with higher weaning and survival rate may be associated with better quality of life.…”

Section: Discussionmentioning

confidence: 46%

“…Patients on PMV are often transferred to subacute care units, such as the respiratory care center (RCC), for continued care and further mechanical ventilator weaning. 1 However, various complications may occur with PMV and hinder the weaning process. Patients on PMV are often deconditioned due to the impact of underlying diseases, side effects from medications, and prolonged time bedridden.…”

Section: Introductionmentioning

confidence: 99%

Effects of Exercise Training on Pulmonary Mechanics and Functional Status in Patients With Prolonged Mechanical Ventilation

et al. 2012

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BACKGROUND:The functional status and outcomes in patients with prolonged mechanical ventilation (PMV) are often limited by poor endurance and pulmonary mechanics, which result from the primary diseases or prolonged time bedridden. We evaluate the impact of exercise training on pulmonary mechanics, physical functional status, and hospitalization outcomes in PMV patients. METHODS: Twenty-seven subjects with PMV in our respiratory care center (RCC) were divided randomly into an exercise training group (n ‫؍‬ 12) and a control group (n ‫؍‬ 15). The exercise program comprised 10 sessions of exercise training. The measurement of pulmonary mechanics and physical functional status (Functional Independence Measurement and Barthel index) were performed pre-study and post-study. The hospitalization outcomes included: days of mechanical ventilation, hospitalization days, and weaning and mortality rates during RCC stay. RESULTS: The training group had significant improvement in tidal volume (143.6 mL vs 192.5 mL, P ‫؍‬ .02) and rapid shallow breathing index after training (162.2 vs 110.6, P ‫؍‬ .009). No significant change was found in the control group except respiratory rate. Both groups had significant improvement in functional status during the study. However, the training group had greater changes in FIM score than the control group (44.6 vs 34.2, P ‫؍‬ .024). The training group also had shorter RCC stay and higher weaning and survival rates than the control group, although no statistical difference was found. CONCLUSIONS: Subjects with PMV in our RCC demonstrated significant improvement in pulmonary mechanics and functional status after exercise training. The application of exercise training may be helpful for PMV patients to improve hospitalization outcomes.

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“…Patients requiring prolonged ventilation are a financial and logistic burden for intensive care units, which is evidenced by the number of ventilation days before admission to the mechanical ventilation weaning station. This number in the study performed in 23 American centres was 34 days [13]; in other single centres -56 [5] or 50 days [7]. Our findings are satisfactory as the median time between admission and transfer was only 25 days (IQR 17; 41 days).…”

Section: Discussionsupporting

confidence: 54%

Weaning centre — siedmioletnie doświadczenia jednego ośrodka

Rojek-Jarmuła¹,

Hombach²,

Gierek³

et al. 2015

Anaesthesiol Intensive Ther

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Background: Weaning from mechanical ventilation is a growing and challenging issue in modern intensive care medicine. We aimed to describe a 7-year experience in weaning from mechanical ventilation of a single centre in Germany. Methods: We retrospectively analysed data regarding 403 patients admitted between 2007 and 2013 with difficult or prolonged mechanical ventilation weaning. Results: There were 261 men (64.8%) in the population. The median age was 72 (IQR 63; 77) years. The underlying reasons for ventilator dependence comprised: post-operative respiratory failure (56.3%), exacerbation of chronic obstructive pulmonary disease (14.4%) and pneumonia (7.4%). A tracheostomy was performed about 9 (IQR 7; 14) days after the last attempt of a spontaneous breathing trial, usually with the percutaneous method (89.3%). The median length of stay was 28 (IQR 20; 41) days. Sixty-five (16.1%) patients died. Among the survivors, complete ventilator independence was achieved in 316 (78.4%) subjects while 94 (29.7%) of subjects required a tracheal tube on discharge. The vast majority of patients were discharged to rehabilitation clinics (56.1%). All of the analysed parameters did not statistically significantly differ between consecutive years in the investigated period. Conclusion: Our initial experience with weaning from mechanical ventilation are encouraging, repeatable in subsequent years of observation and consistent with the literature data. Assessing the predictors of successful mechanical ventilation weaning requires further research.

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Post-Icu Mechanical Ventilation at 23 Long Term Care Hospitals: A Multicenter Outcomes Study.

Cited by 72 publications

References 0 publications

An intermediate respiratory care unit for spinal cord-injured patients. A retrospective study

An intermediate respiratory care unit for spinal cord-injured patients. A retrospective study

Effects of Exercise Training on Pulmonary Mechanics and Functional Status in Patients With Prolonged Mechanical Ventilation

Weaning centre — siedmioletnie doświadczenia jednego ośrodka

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