Protocol-driven weaning from mechanical ventilation: a study into adherence and outcomes

West, Richard; Saidi, Mohammadreza; Dawson, Deborah

doi:10.1186/cc7188

Cited by 1 publication

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“…Therefore, the numerous factors affecting weaning success can be the main reason underlying the different weaning failure/success rates among the results of studies.As reported, about 40% of patients under mechanical ventilation experience difficult weaning, and weaning process decided by the physician is considered as a time-consuming process, subject to inter-rater and other types of biases (21). Accordingly, several protocols and scoring systems have been suggested for prediction of successful weaning from the mechanical ventilator to be used by non-physician technicians to save the physicians' time (10,22); however, they fail to predict successful weaning, especially in patients with prolonged ventilation who display poor compliance (23,24). Several studies have compared the success rate of weaning based on physician-based decision with automated Smart Care™ (DrägerMedical, Lübeck, Germany).…”

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confidence: 99%

The Value of Persian Weaning Tool in Prediction of Patients’ Weaning Outcome Compared with Physician- Directed Approach: A Diagnostic Accuracy Study

Mirzaali

Vakili

Khoddam

2020

J Res Dev Nurs Midw

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Background: One of the important criteria in patients receiving artificial respiration is the time of weaning from the mechanical ventilator. As physician's decision might be somehow subjective, several tools have been suggested for prediction of the time of weaning more objectively. This study aimed to determine the predictive value of Persian Weaning Tool (PWT) compared with Physician-directed approach as the gold standard. Methods: This diagnostic accuracy study was done in 2016-2017 in Two Medical and Educational Centers of Gorgan, Iran. 97 admitted patients in intensive care units, under mechanical ventilation were evaluated. The patients were recruited into the study by a convenience sampling method and evaluated for readiness to wean using two approaches (physician's decision and using PWT). Successful weaning was considered as the ability of patient to breathe spontaneously during the first 48 hours after weaning. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR), as well as the agreement (kappa coefficient) between the two approaches, were calculated. In addition, to compare the differences between variables in two groups, chi-Square, T and man-Whitney tests were used. All analyses were performed using SPSS software ver.16, and MedCalc program ver.13. P<0.05 was considered as statistically significant. Results: Most patients (64.9%) were men. The mean age, duration of hospital admission, and

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