title: A nurse-directed protocol using pulse oximetry to wean mechanically ventilated patients from toxic oxygen concentrations.
abstract: The usual method of weaning mechanically ventilated patients from high FIO2 in our ICU, in which housestaff ordered all ventilator changes in an unstandardized manner (control group), was compared to a nurse-directed protocol that used a single arterial blood gas (ABG) analysis and multiple pulse oximetry measurements. The protocol required an ABG to be obtained upon the initiation of intubation/mechanical ventilation, followed by pulse oximetry measurements obtained in accordance with a standardized timetable. Decreases in FIO2 were guided by these results. It was concluded that a nurse-directed oxygen weaning protocol utilizing a combination of a single ABG and multiple pulse oximetry measurements was safe, reduced the need for ABGs, and decreased the duration of patient exposure to toxic oxygen concentrations.
authors.affiliation: Program in Multidisciplinary Critical Care, University Hospital, SUNY Health Science Center, Syracuse 13210.
authors.forename: L C
authors.initials: LC
authors.lastname: Rotello
authors.forename: J
authors.initials: J
authors.lastname: Warren
authors.forename: M S
authors.initials: MS
authors.lastname: Jastremski
authors.forename: A
authors.initials: A
authors.lastname: Milewski
mesh_terms: D002245:Carbon Dioxide / Q000097:blood; D002985:Clinical Protocols; D006801:Humans; D006863:Hydrogen-Ion Concentration; D010092:Oximetry; D010100:Oxygen / Q000008:administration & dosage / Q000097:blood; D011175:Positive-Pressure Respiration; D013997:Time Factors; D015300:Ventilator Weaning / Q000451:nursing*
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen