title: An evaluation of protocolised weaning on the duration of mechanical ventilation.
abstract: Using a before and after study design, we compared protocolised weaning from mechanical ventilation with usual non-protocolised practice in intensive care. Outcomes (duration of mechanical ventilation, duration of intubation, intensive care stay) and complications (re-intubations, tracheostomy, mortality) were compared between baseline (Phase I) and following implementation of protocolised weaning (Phase II). Over the same period, we collected data in a second (reference) unit to monitor practice changes over time. In the intervention unit, outcomes were longer in Phase II compared with Phase I (all p < 0.005). When adjusted for admission APACHE II score and diagnostic category, only intensive care stay remained significantly longer (p = 0.002). There were significantly more tracheostomies in Phase II (p = 0.004). The reference unit demonstrated no statistically significant differences in study outcomes or complications between Phases. Protocolised weaning did not reduce the duration of mechanical ventilation and was not associated with an increased rate of re-intubation or intensive care unit mortality.
authors.affiliation: Nursing & Midwifery Research Unit, Queen's University Belfast, 21 Stranmillis Road, Belfast, N Ireland. b.blackwood@qub.ac.uk
authors.forename: B
authors.initials: B
authors.lastname: Blackwood
authors.forename: J
authors.initials: J
authors.lastname: Wilson-Barnett
authors.forename: C C
authors.initials: CC
authors.lastname: Patterson
authors.forename: T J
authors.initials: TJ
authors.lastname: Trinder
authors.forename: G G
authors.initials: GG
authors.lastname: Lavery
mesh_terms: D000368:Aged; D002985:Clinical Protocols; D003422:Critical Care / Q000379:methods*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007442:Intubation, Intratracheal; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D014139:Tracheostomy